Adjusted Community Rate | definition of Adjusted Community Rate by Medical dictionary
Adjusted Community Rate
Adjusted Community Rate An insurance premium rate used by health maintenance organizations (HMOs) and competitive medical plans (CMPs) with Medicare risk contracts, which is a calculation of the premium the plan would charge for providing exactly the Medicare-covered benefits to a group account, adjusted to allow for the greater intensity and frequency of utilisation by Medicare recipients.
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References in periodicals archive
The Balanced Budget Act (BBA) of 1997 requires CMS to annually audit the financial records supporting the submissions (i.e., adjusted community rate
proposals (ACRP) or bids) of at least onethird of participating organizations.
However, the "adjusted community rate
premium" is restricted to individuals and small businesses who purchase their care through the purchasing cooperative.