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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.
DxCG 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.