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.
An average cost, normally estimated, for Medicare benefits. This cost is determined by several factors, such as location, age, sex, disability, stage renal disease or institutional status. This cost estimate is then used to figure out how much cost contractors with Medicare should be paid.
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.
An estimate of how much Medicare will spend in a year for an average beneficiary. (See Risk Adjustment.)
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)
Used by the Health Care Financing Administration (HCFA) as the calculation for the funds required to care for Medicare recipients; calculated by county for a 5-year moving average and based on 95% of "fee-for-service" Medicare costs for that county; the standard monthly payment to a federally qualified Medicare HMO contractor containing 122 actuarial stratifications for age, sex, Medicaid eligibility, institutional status, end-stage renal disease (ESRD), and the patient's eligibility for Part A and Part B of Medicare. (Reference DoD Medicare demonstration, pending the outcome of negotiations or legislation).
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.
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.
