What is a healthcare risk score, and who uses it?

A healthcare risk score is a numerical tool that estimates a patient's likelihood of experiencing a specific health outcome, such as readmission, complications, or death, usually within a set time period. It combines information from a patient's medical record—like age, diagnoses, lab results, and procedures—into a single score using a statistical formula. Hospitals, insurers, and care teams use these scores to identify patients who need extra attention, allocate resources, and track quality performance.