Which of the following health record elements impacts HHS-HCC risk scores?

The HHS-HCC risk adjustment model (used for ACA Marketplace plans) calculates a member’s risk score using a combination ofdemographic factorsanddiagnosis codesthat map to HHS-HCCs. Among the listed health record elements,genderis a core demographic variable used in the model’s coefficients because expected healthcare utilization and cost patterns differ by age/sex groupings. In outpatient CDI terms, this is why accurate demographic data capture (including sex) matters alongside complete and specific condition reporting. CPT codes do not drive HHS-HCC risk scores; the model relies on diagnosis reporting (ICD-10-CM) rather than procedure codes for risk category assignment. Discharge status is an encounter/billing element relevant to certain facility payment and quality measures, but it is not a standard HHS-HCC risk score input. Ethnicity is not used as a direct risk adjustment variable in the HHS-HCC model for score calculation. Therefore, gender is the correct element that impacts HHS-HCC risk scores.