            CONVERSION OF COUNTY PER CAPITA COSTS INTO RATES



The "CHOICEYY.CSV" file for year YY (e.g. 98 for 1998 file) contains the 
monthly Medicare+Choice per capita rates of payment by county.  For each 
county there will be six rates of payment (i.e. Aged Part A; Aged Part B; 
Disabled Part A; Disabled Part B; ESRD Part A; ESRD Part B).  
(see the Record Description below for the file layout).

The Medicare+Choice methodology adjusts for age, sex, Medicaid status, 
working status, and institutional status of the Medicare beneficiaries 
in a given county.  Also below are the tables containing the demographic 
cost factors used in this adjustment.  Each factor relates the Medicare 
cost for a person in that demographic cell to the cost for the average 
Medicare beneficiary (Factor = 1.00).

To calculate the actual per capita rates of payment, the rates in the 
CHOICEYY.CSV file must be multiplied by the demographic cost factors.  
The calculation of this monthly payment must be computed separately for 
Part A and Part B using the following steps:

1.   Using the State and County of residence, select the appropriate 
     standardized per capita rate (Aged, Disabled, or ESRD from the 
     CHOICEYY.CSV file).

2.   Using the tables of the demographic cost factors with the proper 
     Part (A or B) and age group (10 categories), select the appropriate 
     factor for the specific sex (male or female) and status 
     (Institutionalized, Medicaid, Medicare, and Working Aged).

3.   Multiply the rate (Step 1) by the factor (Step 2) to calculate the 
     monthly payment.

Note:  Demographic adjustments are not made for ESRD enrollees.  For 
       these cases, the rate (Step 1) is the monthly payment.
                            
                            
                            
                            
1998 DEMOGRAPHIC COST FACTORS FOR THE AGED


                                 PART A - Hospital Insurance

Sex and       Institutional             N o n - I n s t i t u t i o n a l
Age Group                                              Non-           Working
                                  Medicaid           Medicaid           Aged

Male:

85 & Over        2.25                2.60                1.35            .90
80 - 84          2.25                2.35                1.20            .80
75 - 79          2.25                1.95                1.05            .70
70 - 74          2.25                1.50                 .85            .45
65 - 69          1.75                1.15                 .65            .40

Female:

85 & Over        2.10                2.10                1.20            .80
80 - 84          2.10                1.70                1.05            .70
75 - 79          2.10                1.45                 .85            .55
70 - 74          1.80                1.05                 .70            .45
65 - 69          1.45                 .80                 .55            .35




                          PART B - Supplementary Medical Insurance

Sex and       Institutional             N o n - I n s t i t u t i o n a l
Age Group                                              Non-           Working
                                  Medicaid           Medicaid           Aged

Male:

85 & Over        1.95                1.70                1.15           1.00
80 - 84          1.95                1.70                1.15            .90
75 - 79          1.95                1.55                1.10            .80
70 - 74          1.80                1.35                0.95            .65
65 - 69          1.60                1.10                 .80            .45

Female:

85 & Over        1.65                1.25                1.00            .85
80 - 84          1.65                1.25                 .95            .75
75 - 79          1.65                1.25                 .95            .70
70 - 74          1.65                1.15                 .85            .55
65 - 69          1.50                1.05                 .70            .40






1998 DEMOGRAPHIC COST FACTORS FOR THE DISABLED


                                 PART A - Hospital Insurance

Sex and       Institutional             N o n - I n s t i t u t i o n a l
Age Group                                              Non-           Working
                                  Medicaid           Medicaid           Aged
 
Male:

60 - 64           .60                1.85                1.00            N/A
55 - 59           .90                1.60                 .85            N/A
45 - 54          1.10                1.30                 .65            N/A
35 - 44          1.45                1.20                 .70            N/A
UNDER 35         1.80                1.10                 .60            N/A

Female:

60 - 64           .70                1.55                1.30            N/A
55 - 59           .95                1.35                 .95            N/A
45 - 54          1.15                1.20                 .75            N/A
35 - 44          1.40                1.20                 .60            N/A
UNDER 35         1.80                1.20                 .55            N/A
                                 
                                 
                          PART B - Supplementary Medical Insurance

Sex and       Institutional             N o n - I n s t i t u t i o n a l
Age Group                                              Non-           Working
                                  Medicaid           Medicaid           Aged
 
Male:

60 - 64           .95                1.45                 .95            N/A
55 - 59          1.10                1.30                 .75            N/A
45 - 54          1.25                1.15                 .60            N/A
35 - 44          1.50                1.15                 .55            N/A
UNDER 35         1.70                1.10                 .45            N/A

Female:

60 - 64          1.15                1.55                1.20            N/A
55 - 59          1.35                1.35                1.05            N/A
45 - 54          1.60                1.25                 .95            N/A
35 - 44          1.85                1.15                 .85            N/A
UNDER 35         1.95                1.05                 .75            N/A


