HEDIS 2016 Standard Pricing and Risk Adjustment Tables

The risk adjustment tables for the Risk-Adjusted Utilization measures. Please note that some risk adjustment tables are used for all or multiple risk adjusted measures and some are measure-specific.

HEDIS® Risk Adjustment Tables

Shared Risk Adjustment Tables (all measures) *

*These Tables are used for ACO reporting.

HCC-Surg (PCR and RRU measures only)* 

*These Tables are used for ACO reporting

Risk Adjusted Utilization Tables

PCR Risk Adjustment Tables* – Updated December 4, 2015

*These Tables are used for ACO reporting.

IHU Risk Adjustment Tables 

EDU Risk Adjustment Tables 

HPC Risk Adjustment Tables 

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

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