Which of the following databases help determine patient risk?

• A. HCC and ERA
• B. EHR data
• C. ICD-9 codes
• D. PACS systems

Answer: (A)

Determining patient risk relies on translating health information into a standardized, weighted risk score. Hierarchical Condition Categories take a patient’s diagnoses and map them into risk categories that assign specific weights to different conditions, reflecting how much they raise expected future costs or resource use. When you combine that with encounter data used in risk adjustment—often captured as ERA—you get a comprehensive view of a patient’s health status over time from real clinical encounters. This pairing provides the structured, validated means to estimate risk across populations, which is why it’s the best choice.

Electronic health record data is valuable for detailed clinical information but doesn’t by itself provide the standardized risk weights used in these models. ICD-9 codes identify conditions but don’t carry the built-in risk-adjustment weighting. PACS systems store imaging data and aren’t designed for risk scoring.