Adjusted Average Per Capita Cost

(AAPCC) Medicare payments to contracting HMOs and CMPs for enrolled beneficiaries are based upon a formula the uses the adjusted average per capita costs per county as the initial basis for payment, with various demographic and other risk adjustments applied to this rate. The AAPCC has based on actuarial estimates of the per capita cost Medicare incurs paying claims on a fee-for-service (FFS) basis in a beneficiary's county of residence.