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Definition
| The average number of staffed beds that are occupied each day. The average daily census is calculated by dividing the total inpatient days by 365 days. |
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Term
| Unit of service-workload units |
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Definition
| In nursing, workloads are usually the same as patient-days. For some areas, however, workload units might refer to the number of procedures, tests, patient visits, injections, and so forth. |
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Term
| ALOS-average length of stay |
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Definition
| calculated by dividing the number of days stayed (from the date of admission in an in-patient institution) by the number of discharges (including deaths). |
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Term
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Definition
| type of patients served by an institution. A hospital's case mix is usually defined in such patient-related variables as diagnosis, personal characteristics, and patterns of treatment |
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Definition
| Number of hours of work for which a full-time employee is scheduled for a weekly period. Two part-time employees may equal one. |
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Term
| DRGs-Diagnostic related groups |
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Definition
| Rate-setting prospective payment system used by Medicare to determine payment rates for an inpatient hospital stay based on admission diagnosis. Each DRG represents a particular case type for which Medicare provides a flat dollar amount of reimbursement. This set rate may, in actuality, be higher or lower than the cost of treating the patient in a particular hospital. |
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Term
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Definition
| Office procedures that ensure that billable services are recorded and reported for payment. |
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Definition
| the determination of medical necessity for medical an surgical in-hospital, outpatient, and alternative setting treatments for acute and rehabilitation care |
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Term
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Definition
| A method of paying hospitals for actual costs incurred by patients. Those costs must conform to explicit principles defined by third-party payers. |
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Term
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Definition
| Smallest functional unit for which cost control and accountability can be assigned. A nursing unit is usually considered a ______, but there may be others within a unit |
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Term
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Definition
| costs that vary with the volume. Example: payroll costs |
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Term
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Definition
| Costs that do not vary with the volume. Example: mortgage or loan payments |
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Term
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Definition
| Nationwide health insurance program authorized under Title 18 of the Social Security Act that provides benefits to people 65 years of age or older. Medicare coverage also is available to certain groups of people with catastrophic or chronic illness, such as patients with renal failure requiring hemodialysis, regardless of age |
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Term
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Definition
| Federally assisted and state-administered program to pay for medical services on behalf of certain groups of low-income individuals. Generally, there people are not covered by Social Security. Certain groups of people (e.g. the elderly, blind, disabled, members of families with dependent childern, and certain other children and pregnant women) also qualify for coverage if their incomes and resources are sufficiently low |
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Term
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Definition
| Nations that employ a universal health plan provide their citizens with a public health option that they are entitled to. |
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Term
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Definition
| provides health care to uninsured children up to age 19. It is a no-cost health program that pays for children’s hospital care, doctor visits, prescription drugs, shots and more. |
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Term
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Definition
| rate at which dollars are received and dispersed |
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Term
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Definition
| the process businesses use to describe the financial progression of their accounts receivables from the very beginning, when they first acquire product, if they're product based, until they get paid, if they get paid in full. |
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Term
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Definition
a systematic process for calculating and comparing benefits and costs of a project, decision or government policy (hereafter, "project"). CBA has two purposes:
To determine if it is a sound investment/decision (justification/feasibility),
To provide a basis for comparing projects. It involves comparing the total expected cost of each option against the total expected benefits, to see whether the benefits outweigh the costs, and by how much. |
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Term
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Definition
| the difference between a budgeted, planned or standard amount and the actual amount incurred/sold. |
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Term
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Definition
| a tool of budgetary control by evaluation of performance by means of variances between budgeted amount, planned amount or standard amount and the actual amount incurred/sold. Variance analysis can be carried out for both costs and revenues. |
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Term
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Definition
| the difference between what hospitals bill and what they receive in payment from third party payers, most commonly government programs; also known as contractual adjustment. |
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Term
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Definition
| a measure of the efficiency of production. defined as a total output per one unit of a total input. |
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Term
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Definition
| At work, not all time on the clock is spent in productive labor and is legally called nonproductive hours. The law still considers this to be work, however, and it can add up |
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Term
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Definition
| the difference between the purchase price and the costs of bringing to market |
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Term
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Definition
| income that a company receives from its normal business activities, usually from the sale of goods and services to customers. |
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Term
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Definition
| term used to describe a variety of health care plans designed to contain the cost of health care services delivered to members while maintaining the quality of care. |
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Term
| organized delivery system |
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Definition
a legal entity that contracts with a carrier for the purpose of providing or arranging for the provision of health care services to those persons covered under a carrier’s health benefits plan, but which is not a licensed health care facility or other health care provider.
Example: PPO |
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Term
| Prospective reimbursement |
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Definition
| a method of payment to an agency for health care services to be delivered that is based on predictions of what the agency's costs will be for the coming year. |
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Term
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Definition
| Medical practice The type–eg, Medicaid, Medicare, indeminity insurance, managed care–of monies received by a medical practice. Cf Patient mix, Service mix. |
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Term
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Definition
| A prospective payment system that pays health plans or providers a fixed amount per enrollee per month for a defined set of health services, regardless of how many (if any) services are used. |
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