Total per Capita Cost (Population Based, Primary Care)
Identifying Attributes
Care Settings
Primary Care
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Traditional Merit-based Incentive Payment System (MIPS)
Type of Quality Indicator
Outcome
IOM Quality Dimension
Efficiency
Domain
Wait and System Planning / Access
Defining Attributes
Definition
Evaluates the overall cost of care delivered to a patient. The total per capita cost measure is an average of per capita costs across all attributed patients and includes all Medicare Parts A and B costs for one year following the identification of a primary care relationship.
Numerator
Total cost of care to a patient.
Denominator
This is a continuous outcome.
Exclusions
Use of Risk Adjustment
Yes
Risk Adjustments
Patient factors including age, comorbidities
Stratifications
Collection and Reporting Attributes
Type of Data Collection
Administrative data
Data Collection Methods
Merit-Based Incentive Payment System traditional reporting
Frequency of Data Collection
Annually
Frequency of Data Collection in Days
365
Reporting Methods
Reporting Frequency
Annually
Reporting Frequency in Days
365
Indicator Has Recommended Targets
No
Source and Reference Attributes
Evidence Source
Technical Specifications
Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
No
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
02 December 2025
Contents
Actions
Date Modified 02 December 2025