Which factors contribute to determining a plan's overall risk adjustment score?

Get ready for the RADV Audit Training Test. Enhance your skills with multiple choice questions, flashcards, and detailed explanations to excel in your exam.

The correct choice focuses on the elements that directly impact how a plan's overall risk adjustment score is calculated. Risk adjustment scores are primarily determined by demographics, diagnosis codes, and health conditions of the enrolled population. These factors provide essential information that reflects the health status and clinical complexity of individuals within a health plan.

Demographics, which include age and sex, help capture the risk associated with different populations. Diagnosis codes, derived from medical records, indicate the presence of specific health conditions that can elevate a member's risk profile, impacting the amount of reimbursement a plan might receive. Additionally, health conditions directly affect the resource utilization and care requirements for members, making them central to the risk adjustment methodology.

In contrast, the other factors listed do not have a direct influence on the risk adjustment score. Medical staff experience and training, while important for quality of care, do not factor into the calculations for risk scores. Facility location and services offered may influence access to care but do not directly affect individual risk assessments. Lastly, patient satisfaction surveys are more related to quality metrics rather than the financial and clinical risk adjustment framework, which relies on health data rather than subjective measures of patient experience.

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