WAC 182-557-0225. Health home services — Methodology for calculating a person's risk score

The agency uses eight steps to calculate a person's risk score. (1) Step 1. Collect paid claims and health plan encounter data. The agency obtains a set of paid fee-for-service claims and managed care encounters for a client. (a) For clients age 17 and younger, the agency uses all paid claims and encounters within the last 24 months. (b) For clients age 18 and older, the agency uses all paid claims and encounters within the last 15 months. (i) The claims and encounters include the international classification of diseases (ICD) diagnosis codes and national drug codes (NDC) submitted by health care providers. These are used in steps 2 and 3 to create a set of risk categories. (ii) The agency uses two algorithms developed by the University of San Diego: (A) Chronic illness and disability payment system (CDPS) which assigns ICD diagnosis codes to CDPS risk categories (see Table 3 in subsection (5)(b) of this section); and (B) Medical Rx (MRx) which assigns NDCs to MRx risk categories (see Table 2 in subsection (3)(b) of this section). (2) Step 2. Group ICD diagnosis codes into chronic illness and disability payment system risk categories . (a) To group ICD diagnosis codes into the CDPS risk categories (see Table 1 in (b) of this subsection), the agency uses an ICD diagnosis code to CDPS risk categories crosswalk in subsection (1)(b)(ii)(A) of this section. Each of the ICD diagnosis codes listed is assigned to one risk category. If an ICD diagnosis code is not listed in the crosswalk it does not map to a risk category that is used in the calculation of the risk score. (b) Table 1. Titles of Chronic Illness and Disability Payment System Risk Categories CARVH Cardiovascular, very high CARM Cardiovascular, medium CARL Cardiovascular, low CAREL Cardiovascular, extra low PSYH Psychiatric, high PSYM Psychiatric, medium PSYML Psychiatric, medium low PSYL Psychiatric, low SKCM Skeletal, medium SKCL Skeletal, low SKCVL Skeletal, very low CNSH Central Nervous System, high CNSM Central Nervous System, medium CNSL Central Nervous System, low PULVH Pulmonary, very high PULH Pulmonary, high PULM Pulmonary, medium PULL Pulmonary, low GIH Gastro, high GIM Gastro, medium GIL Gastro, low DIA1H Diabetes, type 1 high DIA1M Diabetes, type 1 medium DIA2M Diabetes, type 2 medium DIA2L Diabetes, type 2 low SKNH Skin, high SKNL Skin, low SKNVL Skin, very low RENEH Renal, extra high RENVH Renal, very high RENM Renal, medium RENL Renal, low SUBL Substance abuse, low SUBVL Substance abuse, very low CANVH Cancer, very high CANH Cancer, high CANM Cancer, medium CANL Cancer, low DDM Developmental Disability, medium DDL Developmental Disability, low GENEL Genital, extra low METH Metabolic, high METM Metabolic, medium METVL Metabolic, very low PRGCMP Pregnancy, complete PRGINC Pregnancy, incomplete EYEL Eye, low EYEVL Eye, very low CERL Cerebrovascular, low AIDSH AIDS, high INFH Infectious, high HIVM HIV, medium INFM Infectious, medium INFL Infectious, low HEMEH Hematological, extra high HEMVH Hematological, very high HEMM Hematological, medium HEML Hematological, low CARVH Cardiovascular, very high CARM Cardiovascular, medium CARL Cardiovascular, low CAREL Cardiovascular, extra low PSYH Psychiatric, high PSYM Psychiatric, medium PSYML Psychiatric, medium low PSYL Psychiatric, low SKCM Skeletal, medium SKCL Skeletal, low SKCVL Skeletal, very low CNSH Central Nervous System, high CNSM Central Nervous System, medium CNSL Central Nervous System, low PULVH Pulmonary, very high PULH Pulmonary, high PULM Pulmonary, medium PULL Pulmonary, low GIH Gastro, high GIM Gastro, medium GIL Gastro, low DIA1H Diabetes, type 1 high DIA1M Diabetes, type 1 medium DIA2M Diabetes, type 2 medium DIA2L Diabetes, type 2 low SKNH Skin, high SKNL Skin, low SKNVL Skin, very low RENEH Renal, extra high RENVH Renal, very high RENM Renal, medium RENL Renal, low SUBL Substance abuse, low SUBVL Substance abuse, very low CANVH Cancer, very high CANH Cancer, high CANM Cancer, medium CANL Cancer, low DDM Developmental Disability, medium DDL Developmental Disability, low GENEL Genital, extra low METH Metabolic, high METM Metabolic, medium METVL Metabolic, very low PRGCMP Pregnancy, complete PRGINC Pregnancy, incomplete EYEL Eye, low EYEVL Eye, very low CERL Cerebrovascular, low AIDSH AIDS, high INFH Infectious, high HIVM HIV, medium INFM Infectious, medium INFL Infectious, low HEMEH Hematological, extra high HEMVH Hematological, very high HEMM Hematological, medium HEML Hematological, low (3) Step 3. Group national drug codes (NDCs) into MRx risk categories. (a) To group the NDC codes into MRx risk categories (see Table 2 in (b) of this subsection), the agency uses a NDC code to MRx risk categories crosswalk in subsection (1)(b)(ii)(B) of this section. (b) Table 2. Titles of Medicaid Rx Risk Categories MRx1 Alcoholism MRx2 Alzheimer's MRx3 Anti-coagulants MRx4 Asthma/COPD MRx5 Attention Deficit MRx6 Burns MRx7 Cardiac MRx8 Cystic Fibrosis MRx9 Depression/Anxiety MRx10 Diabetes MRx11 EENT MRx12 ESRD/Renal MRx13 Folate Deficiency MRx14 CMV Retinitis MRx15 Gastric Acid Disorder MRx16 Glaucoma MRx17 Gout MRx18 Growth Hormone MRx19 Hemophilia/von Willebrands MRx20 Hepatitis MRx21 Herpes MRx22 HIV MRx23 Hyperlipidemia MRx24 Infections, high MRx25 Infections, medium MRx26 Infections, low MRx27 Inflammatory/Autoimmune MRx28 Insomnia MRx29 Iron Deficiency MRx30 Irrigating Solution MRx31 Liver Disease MRx32 Malignancies MRx33 Multiple Sclerosis/Paralysis MRx34 Nausea MRx35 Neurogenic Bladder MRx36 Osteoporosis/Pagets MRx37 Pain MRx38 Parkinsons/Tremor MRx39 Prenatal Care MRx40 Psychotic Illness/Bipolar MRx41 Replacement Solution MRx42 Seizure Disorders MRx43 Thyroid Disorder MRx44 Transplant MRx45 Tuberculosis MRx1 Alcoholism MRx2 Alzheimer's MRx3 Anti-coagulants MRx4 Asthma/COPD MRx5 Attention Deficit MRx6 Burns MRx7 Cardiac MRx8 Cystic Fibrosis MRx9 Depression/Anxiety MRx10 Diabetes MRx11 EENT MRx12 ESRD/Renal MRx13 Folate Deficiency MRx14 CMV Retinitis MRx15 Gastric Acid Disorder MRx16 Glaucoma MRx17 Gout MRx18 Growth Hormone MRx19 Hemophilia/von Willebrands MRx20 Hepatitis MRx21 Herpes MRx22 HIV MRx23 Hyperlipidemia MRx24 Infections, high MRx25 Infections, medium MRx26 Infections, low MRx27 Inflammatory/Autoimmune MRx28 Insomnia MRx29 Iron Deficiency MRx30 Irrigating Solution MRx31 Liver Disease MRx32 Malignancies MRx33 Multiple Sclerosis/Paralysis MRx34 Nausea MRx35 Neurogenic Bladder MRx36 Osteoporosis/Pagets MRx37 Pain MRx38 Parkinsons/Tremor MRx39 Prenatal Care MRx40 Psychotic Illness/Bipolar MRx41 Replacement Solution MRx42 Seizure Disorders MRx43 Thyroid Disorder MRx44 Transplant MRx45 Tuberculosis (4) Step 4. Remove duplicate risk categories. After mapping all diagnosis and drug codes to the risk categories, the agency eliminates duplicates of each client's risk categories so that there is only one occurrence of any risk category for each client. (5) Step 5. Select the highest CDPS risk category within a disease group. (a) The agency organizes CPDS risk categories into risk category groups of different intensity levels. The high risk category in each group is used in the calculation of the risk score. The lower level risk categories are eliminated from further calculations. (b) Table 3. Chronic Disease Payment System Risk Category Groups Group Description Risk Categories (Ordered Highest to Lowest Intensity) AIDS/HIV and Infection AIDSH, INFH, HIVM, INFM, INFL Cancer CANVH, CANH, CANM, CANL Cardiovascular CARVH, CARM, CARL, CAREL Central Nervous System CNSH, CNSM, CNSL Diabetes DIA1H, DIA1M, DIA2M, DIA2L Developmental Disability DDM, DDL Eye EYEL, EYEVL Gastrointestinal GIH, GIM, GIL Hematological HEMEH, HEMVH, HEMM, HEML Metabolic METH, METM, METVL Pregnancy PRGCMP, PRGINC Psychiatric PSYH, PSYM, PSYML, PSYL Substance Abuse SUBL, SUBVL Pulmonary PULVH, PULH, PULM, PULL Renal RENEH, RENVH, RENM, RENL Skeletal SKCM, SKCL, SKCVL Skin SKNH, SKNL, SKNVL Group Description Risk Categories (Ordered Highest to Lowest Intensity) AIDS/HIV and Infection AIDSH, INFH, HIVM, INFM, INFL Cancer CANVH, CANH, CANM, CANL Cardiovascular CARVH, CARM, CARL, CAREL Central Nervous System CNSH, CNSM, CNSL Diabetes DIA1H, DIA1M, DIA2M, DIA2L Developmental Disability DDM, DDL Eye EYEL, EYEVL Gastrointestinal GIH, GIM, GIL Hematological HEMEH, HEMVH, HEMM, HEML Metabolic METH, METM, METVL Pregnancy PRGCMP, PRGINC Psychiatric PSYH, PSYM, PSYML, PSYL Substance Abuse SUBL, SUBVL Pulmonary PULVH, PULH, PULM, PULL Renal RENEH, RENVH, RENM, RENL Skeletal SKCM, SKCL, SKCVL Skin SKNH, SKNL, SKNVL (6) Step 6. Determine age/gender category. (a) For each client, the agency selects the appropriate age/gender category. The 11 categories are listed in Table 4 in (b) of this subsection. The categories for ages below five and above 65 are gender neutral. (b) Table 4. Age/Gender Categories Age Gender Age <1 Age 1 to 4 Age 5 to 14 Male Age 5 to 14 Female Age 15 to 24 Male Age 15 to 24 Female Age 25 to 44 Male Age 25 to 44 Female Age 45 to 64 Male Age 45 to 64 Female Age 65+ Age Gender Age <1 Age 1 to 4 Age 5 to 14 Male Age 5 to 14 Female Age 15 to 24 Male Age 15 to 24 Female Age 25 to 44 Male Age 25 to 44 Female Age 45 to 64 Male Age 45 to 64 Female Age 65+ (7) Step 7. Apply risk weights. (a) The agency assigns each risk category and age/gender category a weight. The weight comes from either the model for clients who are age 17 and younger or from the model for clients age 18 and older. (b) In each model there are three types of weights. (i) Age/gender – Weights that correspond to the age/gender category of a client. (ii) CDPS – Weights that correspond to 58 of the CDPS risk categories. (iii) MRx – Weights that correspond to 45 of the MRx risk categories. (c) Table 5. Risk Score Weights Category Type Category Description Weights for Children (age <18) Weights for Adults (age 18+) Age/Gender Age <1 Clients of age less than 1 0.91261 0.00000 Age 1 to 4 Clients age 1 to 4 0.31764 0.00000 Age 5 to 14, Male Male clients age 5 to 14 0.25834 0.00000 Age 5 to 14, Female Female clients age 5 to 14 0.26338 0.00000 Age 15 to 24, Male Male clients age 15 to 24 0.25662 -0.01629 Age 15 to 24, Female Female clients age 15 to 24 0.29685 0.03640 Age 25 to 44, Male Male clients age 25 to 44 0.00000 0.04374 Age 25 to 44, Female Female clients age 25 to 44 0.00000 0.06923 Age 45 to 64, Male Male clients age 45 to 64 0.00000 0.13321 Age 45 to 64, Female Female clients age 45 to 64 0.00000 0.06841 Age 65+ Clients age 65 and older 0.00000 -0.05623 CDPS CARVH Cardiovascular, very high 0.84325 2.86702 CARM Cardiovascular, medium 0.33428 0.73492 CARL Cardiovascular, low 0.12835 0.24620 CAREL Cardiovascular, extra low 0.04307 0.06225 PSYH Psychiatric, high 0.40351 0.27085 PSYM Psychiatric, medium 0.23892 0.00000 PSYML Psychiatric, medium low 0.13796 0.00000 PSYL Psychiatric, low 0.07675 0.00000 SKCM Skeletal, medium 0.21071 0.42212 SKCL Skeletal, low 0.08343 0.15467 SKCVL Skeletal, very low 0.06244 0.06773 CNSH Central Nervous System, high 0.80483 0.78090 CNSM Central Nervous System, medium 0.31945 0.40886 CNSL Central Nervous System, low 0.15106 0.18261 PULVH Pulmonary, very high 1.14056 4.01723 PULH Pulmonary, high 0.34356 0.39309 PULM Pulmonary, medium 0.35587 0.31774 PULL Pulmonary, low 0.11315 0.13017 GIH Gastro, high 0.65934 1.34924 GIM Gastro, medium 0.24699 0.24372 GIL Gastro, low 0.09767 0.05104 DIA1H Diabetes, type 1 high 0.27018 1.04302 DIA1M Diabetes, type 1 medium 0.27018 0.23620 DIA2M Diabetes, type 2 medium 0.13647 0.17581 DIA2L Diabetes, type 2 low 0.13647 0.09635 SKNH Skin, high 0.56322 0.37981 SKNL Skin, low 0.23664 0.45155 SKNVL Skin, very low 0.05697 0.02119 RENEH Renal, extra high 1.80489 3.41999 RENVH Renal, very high 0.59311 0.69251 RENM Renal, medium 0.28630 0.92846 RENL Renal, low 0.21048 0.17220 SUBL Substance Abuse, low 0.15170 0.16104 SUBVL Substance Abuse, very low 0.01794 0.08784 CANVH Cancer, very high 1.19700 2.80074 CANH Cancer, high 0.51985 0.97173 CANM Cancer, medium 0.22164 0.38022 CANL Cancer, low 0.10350 0.22625 DDM Developmental Disability, medium 0.50073 0.27818 DDL Developmental Disability, low 0.19696 0.05913 GENEL Genital, extra low 0.00790 0.01121 METH Metabolic, high 0.47167 0.47226 METM Metabolic, medium 0.26297 0.11310 METVL Metabolic, very low 0.11546 0.18678 PRGCMP Pregnancy, complete 0.00244 0.00000 PRGINC Pregnancy, incomplete 0.12631 0.51636 EYEL Eye, low 0.09919 0.13271 EYEVL Eye, very low 0.02835 0.00000 CERL Cerebrovascular, low 0.14294 0.00000 AIDSH AIDS, high 0.70597 0.47361 INFH Infectious, high 0.70597 0.79689 HIVM HIV, medium 0.26129 0.07937 INFM Infectious, medium 0.26129 0.79689 INFL Infectious, low 0.07784 0.05617 HEMEH Hematological, extra high 5.37808 12.71981 HEMVH Hematological, very high 0.72873 3.08836 HEMM Hematological, medium 0.37824 0.63211 HEML Hematological, low 0.18676 0.25601 MRx MRx1 Alcoholism 0.05982 0.01924 MRx2 Alzheimer's 0.00000 0.08112 MRx3 Anti-coagulants 0.34428 0.13523 MRx4 Asthma/COPD 0.08758 0.05751 MRx5 Attention Deficit 0.00000 0.00779 MRx6 Burns 0.16633 0.00000 MRx7 Cardiac 0.0906 0.06425 MRx8 Cystic Fibrosis 0.50399 0.37265 MRx9 Depression/Anxiety 0.06743 0.09436 MRx10 Diabetes 0.1519 0.17046 MRx11 EENT 0.00000 0.00072 MRx12 ESRD/Renal 1.24598 1.20707 MRx13 Folate Deficiency 0.17973 0.11899 MRx14 CMV Retinitis 0.37762 0.00000 MRx15 Gastric Acid Disorder 0.10082 0.15470 MRx16 Glaucoma 0.04221 0.12971 MRx17 Gout 0.00000 0.00000 MRx18 Growth Hormone 0.9741 1.59521 MRx19 Hemophilia/von Willebrands 13.56192 89.14461 MRx20 Hepatitis 0.03018 0.00000 MRx21 Herpes 0.0348 0.01725 MRx22 HIV 0.65537 1.01178 MRx23 Hyperlipidemia 0.00000 0.03791 MRx24 Infections, high 1.38405 1.51663 MRx25 Infections, medium 0.07462 0.06192 MRx26 Infections, low 0.00000 0.00918 MRx27 Inflammatory/Autoimmune 0.08075 0.20046 MRx28 Insomnia 0.07093 0.06437 MRx29 Iron Deficiency 0.13306 0.15054 MRx30 Irrigating Solution 0.87573 0.16387 MRx31 Liver Disease 0.45314 0.22681 MRx32 Malignancies 0.36859 0.44200 MRx33 Multiple Sclerosis/Paralysis 0.0345 0.04353 MRx34 Nausea 0.18219 0.17120 MRx35 Neurogenic Bladder 0.15282 0.07675 MRx36 Osteoporosis/Pagets 0.00000 0.00000 MRx37 Pain 0.0295 0.04151 MRx38 Parkinsons/Tremor 0.17163 0.06257 MRx39 Prenatal Care 0.00000 0.13192 MRx40 Psychotic Illness/Bipolar 0.22819 0.20274 MRx41 Replacement Solution 0.58622 1.49405 MRx42 Seizure Disorders 0.23997 0.19837 MRx43 Thyroid Disorder 0.03948 0.06326 MRx44 Transplant 0.37388 0.05810 MRx45 Tuberculosis 0.20006 0.00000 Category Type Category Description Weights for Children (age <18) Weights for Adults (age 18+) Age/Gender Age <1 Clients of age less than 1 0.91261 0.00000 Age 1 to 4 Clients age 1 to 4 0.31764 0.00000 Age 5 to 14, Male Male clients age 5 to 14 0.25834 0.00000 Age 5 to 14, Female Female clients age 5 to 14 0.26338 0.00000 Age 15 to 24, Male Male clients age 15 to 24 0.25662 -0.01629 Age 15 to 24, Female Female clients age 15 to 24 0.29685 0.03640 Age 25 to 44, Male Male clients age 25 to 44 0.00000 0.04374 Age 25 to 44, Female Female clients age 25 to 44 0.00000 0.06923 Age 45 to 64, Male Male clients age 45 to 64 0.00000 0.13321 Age 45 to 64, Female Female clients age 45 to 64 0.00000 0.06841 Age 65+ Clients age 65 and older 0.00000 -0.05623 CDPS CARVH Cardiovascular, very high 0.84325 2.86702 CARM Cardiovascular, medium 0.33428 0.73492 CARL Cardiovascular, low 0.12835 0.24620 CAREL Cardiovascular, extra low 0.04307 0.06225 PSYH Psychiatric, high 0.40351 0.27085 PSYM Psychiatric, medium 0.23892 0.00000 PSYML Psychiatric, medium low 0.13796 0.00000 PSYL Psychiatric, low 0.07675 0.00000 SKCM Skeletal, medium 0.21071 0.42212 SKCL Skeletal, low 0.08343 0.15467 SKCVL Skeletal, very low 0.06244 0.06773 CNSH Central Nervous System, high 0.80483 0.78090 CNSM Central Nervous System, medium 0.31945 0.40886 CNSL Central Nervous System, low 0.15106 0.18261 PULVH Pulmonary, very high 1.14056 4.01723 PULH Pulmonary, high 0.34356 0.39309 PULM Pulmonary, medium 0.35587 0.31774 PULL Pulmonary, low 0.11315 0.13017 GIH Gastro, high 0.65934 1.34924 GIM Gastro, medium 0.24699 0.24372 GIL Gastro, low 0.09767 0.05104 DIA1H Diabetes, type 1 high 0.27018 1.04302 DIA1M Diabetes, type 1 medium 0.27018 0.23620 DIA2M Diabetes, type 2 medium 0.13647 0.17581 DIA2L Diabetes, type 2 low 0.13647 0.09635 SKNH Skin, high 0.56322 0.37981 SKNL Skin, low 0.23664 0.45155 SKNVL Skin, very low 0.05697 0.02119 RENEH Renal, extra high 1.80489 3.41999 RENVH Renal, very high 0.59311 0.69251 RENM Renal, medium 0.28630 0.92846 RENL Renal, low 0.21048 0.17220 SUBL Substance Abuse, low 0.15170 0.16104 SUBVL Substance Abuse, very low 0.01794 0.08784 CANVH Cancer, very high 1.19700 2.80074 CANH Cancer, high 0.51985 0.97173 CANM Cancer, medium 0.22164 0.38022 CANL Cancer, low 0.10350 0.22625 DDM Developmental Disability, medium 0.50073 0.27818 DDL Developmental Disability, low 0.19696 0.05913 GENEL Genital, extra low 0.00790 0.01121 METH Metabolic, high 0.47167 0.47226 METM Metabolic, medium 0.26297 0.11310 METVL Metabolic, very low 0.11546 0.18678 PRGCMP Pregnancy, complete 0.00244 0.00000 PRGINC Pregnancy, incomplete 0.12631 0.51636 EYEL Eye, low 0.09919 0.13271 EYEVL Eye, very low 0.02835 0.00000 CERL Cerebrovascular, low 0.14294 0.00000 AIDSH AIDS, high 0.70597 0.47361 INFH Infectious, high 0.70597 0.79689 HIVM HIV, medium 0.26129 0.07937 INFM Infectious, medium 0.26129 0.79689 INFL Infectious, low 0.07784 0.05617 HEMEH Hematological, extra high 5.37808 12.71981 HEMVH Hematological, very high 0.72873 3.08836 HEMM Hematological, medium 0.37824 0.63211 HEML Hematological, low 0.18676 0.25601 MRx MRx1 Alcoholism 0.05982 0.01924 MRx2 Alzheimer's 0.00000 0.08112 MRx3 Anti-coagulants 0.34428 0.13523 MRx4 Asthma/COPD 0.08758 0.05751 MRx5 Attention Deficit 0.00000 0.00779 MRx6 Burns 0.16633 0.00000 MRx7 Cardiac 0.0906 0.06425 MRx8 Cystic Fibrosis 0.50399 0.37265 MRx9 Depression/Anxiety 0.06743 0.09436 MRx10 Diabetes 0.1519 0.17046 MRx11 EENT 0.00000 0.00072 MRx12 ESRD/Renal 1.24598 1.20707 MRx13 Folate Deficiency 0.17973 0.11899 MRx14 CMV Retinitis 0.37762 0.00000 MRx15 Gastric Acid Disorder 0.10082 0.15470 MRx16 Glaucoma 0.04221 0.12971 MRx17 Gout 0.00000 0.00000 MRx18 Growth Hormone 0.9741 1.59521 MRx19 Hemophilia/von Willebrands 13.56192 89.14461 MRx20 Hepatitis 0.03018 0.00000 MRx21 Herpes 0.0348 0.01725 MRx22 HIV 0.65537 1.01178 MRx23 Hyperlipidemia 0.00000 0.03791 MRx24 Infections, high 1.38405 1.51663 MRx25 Infections, medium 0.07462 0.06192 MRx26 Infections, low 0.00000 0.00918 MRx27 Inflammatory/Autoimmune 0.08075 0.20046 MRx28 Insomnia 0.07093 0.06437 MRx29 Iron Deficiency 0.13306 0.15054 MRx30 Irrigating Solution 0.87573 0.16387 MRx31 Liver Disease 0.45314 0.22681 MRx32 Malignancies 0.36859 0.44200 MRx33 Multiple Sclerosis/Paralysis 0.0345 0.04353 MRx34 Nausea 0.18219 0.17120 MRx35 Neurogenic Bladder 0.15282 0.07675 MRx36 Osteoporosis/Pagets 0.00000 0.00000 MRx37 Pain 0.0295 0.04151 MRx38 Parkinsons/Tremor 0.17163 0.06257 MRx39 Prenatal Care 0.00000 0.13192 MRx40 Psychotic Illness/Bipolar 0.22819 0.20274 MRx41 Replacement Solution 0.58622 1.49405 MRx42 Seizure Disorders 0.23997 0.19837 MRx43 Thyroid Disorder 0.03948 0.06326 MRx44 Transplant 0.37388 0.05810 MRx45 Tuberculosis 0.20006 0.00000 (8) Step 8. Sum risk weights to obtain the risk score. After obtaining the weights that correspond to a client's age/gender category and set of risk categories, the agency takes a sum of the values of all of the weights. This sum is the risk score for a client.