Which two models are used to calculate a RAF score properly?

The correct choice, which identifies the two models used to calculate a Risk Adjustment Factor (RAF) score, is the Additive and Hierarchical models.

The Additive model calculates RAF scores by summing up the individual risk scores for each condition that the patient has, thus providing a straightforward method to determine the overall risk. This approach is particularly beneficial for a clear aggregation of risk factors without taking into account the hierarchy of conditions.

On the other hand, the Hierarchical model, also known as the Hierarchical Condition Category (HCC) model, recognizes that certain conditions can have a more significant impact on risk than others. It prioritizes more severe or clinically relevant conditions, ensuring that when calculating the total risk score, higher-severity conditions are given precedence over lower-severity ones, which can lead to a more accurate representation of a patient’s overall health status.

These two models complement each other in the RAF scoring process by providing a thorough and nuanced understanding of patient risk, facilitating better resource allocation and management in healthcare settings.