Câu 29: AHM-520: Health Plan Finance and Risk Management

Health plans with risk-based Medicare contracts are required to calculate and submit to CMS a Medicare adjusted community rate (Medicare ACR). Medicare ACR can be defined as the:

1. A. Estimated cost of providing services to a beneficiary under Medicare FFS, adjusted for factors such as age and gender
2. B. Health plan’s estimate of the premium it would charge Medicare enrollees in the absence of Medicare payments to the health plan — đáp án hiện tại
3. C. Average amount the health plan expects to receive from CMS per beneficiary covered
4. D. Health plan’s actual costs of providing benefits to Medicare enrollees in a given year