{
  "name": "risk-adjustment-hcc-mcp",
  "title": "HealthMesh · CMS-HCC Risk Adjustment MCP",
  "version": "0.1.1",
  "description": "CMS Medicare Advantage risk adjustment for payment year 2027: ICD-10-CM code -> HCC mappings for the CMS-HCC V28 and V22, ESRD V24 and V21 and RxHCC V08 models (CMS 2027 initial mappings), HCC labels, hierarchies, interactions and V28 relative factors, and a CMS-HCC V28 risk score calculator ported from CMS's official PY2027 Python model software (verified against it on 300 test beneficiaries), with the 2027 normalization factor (1.079) and MA coding adjustment (5.90%).",
  "healthmesh_domain": "Quality & Risk",
  "datasets": [
    "QUAL-06"
  ],
  "mcp_endpoint": "https://risk-adjustment-hcc.healthmesh.ai/mcp",
  "transport": "Streamable HTTP (stateless, JSON responses)",
  "authorization": "none",
  "auth_mode": "off",
  "docs": "https://github.com/HendrikK/healthmesh/tree/main/servers/risk-adjustment-hcc-mcp#readme",
  "contact": "hendrik.kleine@gmail.com",
  "data_source": {
    "name": "CMS PY2027 risk adjustment model software + ICD-10-CM mappings; CY2027 Rate Announcement",
    "url": "https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment/2027-model-software-icd-10-mappings",
    "license": "U.S. Government work, public domain",
    "refresh": "on each CMS mappings release (initial, midyear, final); bundled, GitHub Actions checks the CMS page weekly"
  },
  "tools": [
    {
      "name": "hcc_map_icd10",
      "title": "Map ICD-10-CM codes to HCCs",
      "description": "Maps ICD-10-CM diagnosis codes to the CMS risk adjustment categories for payment year 2027 (CMS-HCC V28 payment model, plus V22, ESRD V24/V21 and RxHCC V08), with HCC labels, the CMS age/sex edits that can block a V28 mapping, and which of the given codes' V28 HCCs survive the hierarchies. Codes that map to no HCC are flagged. Or search code descriptions with description_query. Examples: Which HCC is I50.22 in V28? Does F32.A map to an HCC?"
    },
    {
      "name": "hcc_calculate_risk_score",
      "title": "Calculate a CMS-HCC V28 risk score",
      "description": "Estimates a Medicare Advantage beneficiary's PY2027 CMS-HCC V28 risk score from demographics and ICD-10-CM diagnoses, using a port of CMS's official PY2027 Python model software (verified against it): MCE age/sex edits, hierarchies, interactions, payment-HCC counts and the segment relative factors, then the 2027 normalization factor (1.079) and MA coding adjustment (5.90%). Returns the score for the chosen segment and all segments, with every contributing factor. Estimate only. Example: risk score for a 70-year-old woman with heart failure (I50.22) and CKD stage 4 (N18.4)."
    },
    {
      "name": "hcc_get_category",
      "title": "Look up an HCC",
      "description": "Returns an HCC's label, its hierarchy (which HCCs it drops and which drop it), diagnosis groups and interactions it belongs to, its V28 relative factors by segment, and the ICD-10-CM codes that map to it. Omit hcc to list all HCCs of a model. Examples: What is V28 HCC 37? Which HCCs does HCC 17 drop?"
    },
    {
      "name": "hcc_describe_dataset",
      "title": "Describe the risk adjustment data",
      "description": "Explains which CMS risk adjustment models and files are loaded for payment year 2027 (why V28 only, what 'V24' means in CMS's files), the segments, normalization and coding adjustment, how the calculator was verified, and the main caveats."
    }
  ]
}