ADJUSTED AVERAGE PER CAPITA COST. An estimate of how much Medicare will spend in a year for an average beneficiary. (See Risk Adjustment.)
Adjusted Average Per Capita Cost. The basis of reimbursement to health maintenance organizations (HMOs) under Medicare risk contracts; the average monthly amount received per enrollee is currently calculated as 95 percent of the average costs to deliver medical care in the fee-for-service sector.
Adjusted Average Per Capita Cost. The estimated average cost of Medicare benefits established on a per county basis _ factors include age, sex, Medicaid, institutional status, disability, and end stage renal disease status. Used to determine payments to cost contractors for Medicare benefits. (H)
Adjusted Average Per Capita Cost. The estimated average fee-for-service cost of Medicare benefits for an individual by county of residence. It is based on the following factors: age, sex, institutional status, Medicaid, disability, and end stage renal disease status. HCFA uses the AAPCCs as a basis for making monthly payments to TEFRA contractors.
Average Area Per Capita Cost. Medicare system ofdetermining the costs of delivering care to Medicare recipients. This isused as the basis for reimbursing the providers of care to Medicarepatients. It is considered seriously flawed because of out-of-datestatistics that were felt to be incorrect to begin with.
Area Adjusted Per Capita Cost. How much managed care plans get paid.
Adjusted average per capita cost. The best estimate of the Health Care Financing Administration (HCFA) of the cost to care for Medicare recipients under fee-for-service. The AAPCC is made up of 122 different rate cells, with 120 of them adjusted for age, sex, Medicaid eligibility, institutional status and the obtainment of both Medicare Part A and Part B. The remaining two cells are for individuals with end-stage renal disease.
Adjusted Average Per Capita Cost. HCFA's best estimate of the amount of money care costs for Medicare recipients under fee-for-service Medicare in a given area. The AAPCC is made up of 122 different rate cells; 120 of them are factored for age, sex, Medicaid eligibility, institutional status, and whether a person has both part A and part B of Medicare.