RAF Score

Risk Adjustment Factor. The numeric multiplier applied to base capitation in Medicare Advantage (and ACA marketplace) reflecting patient health risk. Calculated by summing demographic factors plus all captured HCC coefficients per beneficiary per year. Higher RAF means higher monthly capitation payment. Baseline RAF is 1.0; complex chronic patients can exceed 3.0. Each 0.1 RAF increase represents about $1,000 to $1,500 in annual MA revenue per member.