See What an Unrecaptured Condition Is Actually Worth
eClinicalWorks can hold a patient's problem list without blinking. It has no year-over-year comparison built in, so a chronic condition that quietly didn't get re-documented this year looks exactly the same in the chart as one that did.
2026 is the first year Medicare Advantage risk adjustment runs entirely on the CMS-HCC V28 model, which compresses some condition weights lower than the old V24 model did for the same clinical picture. This calculator uses the real 2026 dollar-per-RAF-point figure, so a dropped condition shows up as an actual number instead of a vague sense that something got missed.
What's Inside This Calculator?
One workbook, three tabs: the real 2026 RAF dollar value, a place to log every condition, and a ranked list of where the recapture gap costs the most.
1. RAF Value & V28 Reference
- The national average base rate and the dollar value per RAF point are both built in for 2026
- V28's transition facts are documented here too, including why some conditions carry less weight than they did under V24 for the same patient
- Swap in your plan's actual county benchmark rate the moment you have it; the national average is a starting point, not your contract
- Every figure is sourced and dated, not a rounded guess
2. HCC Recapture Data Input
- Provider, patient, condition, and RAF weight get logged once per chronic condition per patient
- Mark whether each condition was recaptured this year at a genuine face-to-face visit
- Unrecaptured conditions show their full dollar value at risk automatically
- Nothing here suggests a diagnosis code; it only tracks what's already been documented
3. Recapture Diagnostic Summary
- Every provider's recapture rate and dollar exposure roll up into one view
- Providers rank by dollars at risk, not by how many patients they see
- Low recapture rates get flagged automatically, so outreach scheduling knows where to start
- Rerun it as visits happen throughout the year, not just once at year-end
Built for Healthcare Leaders Responsible for Risk Adjustment & Value-Based Performance
Built for the people who find out a condition wasn't recaptured after the risk score already dropped, not before.
