19 Terms
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Managed care
A health care practice intended to streamline services and provide high quality, cost-effective care.
Industry: Health care
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Managed care
case-mix index
Health care; Managed care
A measure of the relative costliness of treating in an inpatient setting. An index of 1.05, for example, means that the facility’s patients are 5% more costly than average.
occupancy rate
Health care; Managed care
A measure of the usage of the licensed beds during the reporting period that is derived by dividing the patient days in the reporting period by the licensed bed days in the reporting period. A ...
PPS inpatient margin
Health care; Managed care
A measure that compares PPS operating and capital payments with Medicare-allowable inpatient operating and capital costs. It is calculated by subtracting total Medicare-allowable inpatient operating ...
PPS operating margin
Health care; Managed care
A measure that compares PPS operating payments with Medicare-allowable inpatient operating costs. This measure excludes Medicare costs and payments for capital, direct medical education, organ ...
total margin
Health care; Managed care
A measure that compares total hospital revenue and expenses for inpatient, outpatient, and nonpatient care activities. Calculated by subtracting total expenses from total revenue and dividing by ...
health indicator
Health care; Managed care
A measure that reflects, or indicates, the state of health of persons in a defined population (e.g., the infant mortality rate).
hospital days per 1,000
Health care; Managed care
A measurement of the number of days of hospital care HMO members use in a year. It is calculated as follows: Total number of days spent in a hospital by members divided by total members. This ...
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