Hierarchical Condition Categories (HCC)

Hierarchical Condition Categories (HCC) are a system used by Medicare to assess the health status of beneficiaries based on their medical conditions. It groups related diagnoses into categories that influence healthcare costs and risk adjustments. The purpose is to ensure that providers and plans receive appropriate reimbursement for caring for patients with more complex health issues. HCCs consider the severity and hierarchy of conditions, so more serious health problems take precedence. This approach helps healthcare programs allocate resources fairly and tailor services to individual patient needs, promoting better coordination and quality of care.