RxHCC Normalization Factor: 2027 Values and How They Work
The normalization factor keeps the program-wide average risk score at 1.0 year over year, absorbing coding trend in the FFS population. Your plan's raw RxHCC score is divided by the normalization factor before payment — so a higher factor means the same documentation pays less.
The finalized CY2027 factors
| Model / population | CY2027 normalization factor |
|---|---|
| 2027 RxHCC model (2023/2024 calibration) — MA-PD plans | 1.109 |
| 2027 RxHCC model (2023/2024 calibration) — PDPs | 1.005 |
| 2018/2019 calibration (PACE only, 50% of blend) | 1.237 |
Source: CY2027 Rate Announcement, Attachment VIII. CMS calculates the MA-PD/PDP factors by multiple linear regression over average 2020–2024 FFS risk scores, with a flag for dates of service before vs after the onset of COVID-19. PACE uses a historical linear slope over 2016–2020 average scores.
The payment math
A raw MA-PD score of 1.554 pays as 1.554 / 1.109 = 1.40. The same raw score in a PDP pays as 1.554 / 1.005 = 1.55. That ~10-point gap between plan types is pure denominator — before any difference in the coefficients themselves, which are also plan-type-segmented for the first time in 2027.
Why normalization is not "net zero" for your plan
CMS designs normalization to be program-wide neutral. It is not neutral for any individual plan: if your population's documented acuity grows slower than the FFS trend embedded in the factor, you lose ground every year without a single coding error. Plans that treat documentation improvement as optional are compounding a ~1–2% annual headwind.
Frequently asked questions
Is 1.109 an MA-PD penalty?
No — it reflects faster measured risk-score growth in the MA-PD-relevant FFS comparison data. But functionally it raises the documentation bar for MA-PD plans relative to PDPs.
Where is this in the Rate Announcement?
Attachment VIII, in the RxHCC normalization section, with regression detail in the accompanying tables.