What does the CMS-HCC model aim to predict?

The CMS-HCC (Centers for Medicare & Medicaid Services Hierarchical Condition Categories) model is specifically designed to predict healthcare expenditures for Medicare beneficiaries. This model uses a combination of demographic information and clinical diagnoses to assess the expected medical costs for patients covered by Medicare. By evaluating these factors, the model groups patients into categories that reflect their health status and anticipated healthcare expenses.

In this context, predicting full Part A and Part B Medicare expenditures means estimating the total costs associated with inpatient and outpatient services, including hospital stays and physician visits. This information is critical for Medicare and healthcare providers to plan budgets, allocate resources, and ensure that adequate services are provided to beneficiaries based on their health needs.

Other options, such as patient satisfaction rates, current health status of patients, or in-home care delivery costs, do not directly align with the predictive focus of the CMS-HCC model. While these aspects may be relevant in healthcare, they do not form the basis of the financial predictions that the CMS-HCC model is intended to make. Thus, understanding that the primary role of the CMS-HCC model is to forecast Medicare expenditures clarifies why it is aligned with that specific answer choice.