Risk Adjustment Data Validation (RADV) Audit Training 2025 – 400 Free Practice Questions to Pass the Exam

The correct choice is the CDPS model, which stands for Chronic Illness and Disability Payment System. This model is designed to assess the risk of populations based on their health status and aims to allocate resources accordingly. It categorizes individuals into high, medium, and low risk levels, allowing for a more nuanced approach to managing health care costs and improving patient outcomes. By segmenting risk in this manner, the CDPS helps payers and providers understand the varying healthcare needs of their populations, leading to targeted interventions and better resource allocation.

The other models mentioned do not employ this specific risk categorization method. The HCC (Hierarchical Condition Categories) model focuses on classifying illnesses and their complexities but does not distinctly label risks as high, medium, or low in the same way that CDPS does. The ACA-HHS model, which relates to the Affordable Care Act, has its own criteria for adjusting risk but does not specifically utilize high, medium, and low risk categorizations. Lastly, the Medicare Advantage plans often use a combination of these models for risk adjustment, but they do not specifically define risk tiers as high, medium, and low. Thus, CDPS is uniquely characterized by this risk stratification approach.