risk-adjustment-strategy
Installation
SKILL.md
Risk Adjustment Strategy — Reasoning Skill
Overview
Guide the agent through CMS-HCC risk adjustment methodology, model version differences, hierarchy resolution, coding gap identification, and audit-defensible documentation requirements. This skill encodes regulatory and actuarial knowledge for risk adjustment programs, primarily Medicare Advantage (Part C).
Usage
- Reason about CMS-HCC model versions (V24/V28), blended transition, and hierarchy resolution
- Identify coding gaps and design audit-defensible recapture strategies