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Question

What percentiles (formerly Category Codes) should I apply when using risk models?

Answer

The percentile ranges indicate the level of risk that an individual has for a disease or condition against a national percentile. It is important to select percentiles in combination with a Consumer or Patient Risk model in order to include individuals who are at a certain risk level for a particular disease or condition.

The percentiles are defined as follows:

  • top 0.5th percentile - the highest level of risk (previously known as Category Code 7)
  • between 98.5th and 99.5th percentile (previously known as Category Code 6)
  • between 96th and 98.5th percentile (previously known as Category Code 5)
  • between 91st and 96th percentile (previously known as Category Code 4)
  • between 81st and 91st percentile (previously known as Category Code 3)
  • between 56th and 81st percentile (previously known as Category Code 2)
  • in bottom 56th percentile (previously known as Category Code 1)

Best practice: Include risk percentiles 91% and higher (the 4 percentile groups printed in bold above) for both the Consumer and Patient Risk models. For your convenience, the default is set to the best practice recommendation - top 9% (91% and up).

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