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The evolution of DxCG, the gold standard in risk adjustment and predictive modeling

Updated in 2022 for DxCG's 25th anniversary, this is the story of the birth and evolution of one of the earliest and most accurate risk assessment and predictive modeling solutions in the industry.

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The foundational role of accurate risk assessment has been recognized for decades, with risk adjustment and predictive modeling serving as cornerstones of modern value-based healthcare. Healthcare payers use risk adjusters and predictive models to better align healthcare budgeting and payment. Propelled by organizations such as the Centers for Medicare & Medicaid Services (CMS), risk adjusters and predictive models are cemented in the actuarial efforts of payer organizations across the country.

Cotiviti's DxCG Intelligence grew out of the federally funded academic research conducted by its founders, who developed the hierarchical condition categories (HCCs) that CMS uses for reimbursement today. Over the past two decades, providers, health plans, governments, and researchers have adopted DxCG for use across all facets of healthcare delivery.

In 2021, DxCG celebrated its 25th anniversary, an occasion to reexamine its fascinating history and to understand its importance in advancing the science of risk adjustment and predictive modeling. Read our white paper to learn about DxCG's fascinating history and the latest updates included in version 6.0, including social determinants of health (SDoH) classifications to identify individuals with socioeconomic and psychosocial circumstances such as homelessness, poverty, and abuse.