Glossary of Healthcare Terms

Consists of several different subcategories of benchmarking and includes any inter-entity comparison.

EST is a noninvasive procedure used to treat chronic heel pain by increasing bloodflow and breaking down calcification deposits in soft tissue.

Actions taken by a hospital facility against an individual related to obtaining payment of a bill for care covered under the hospital facility

"The refraction test is an eye exam that measures a person's prescription for eyeglasses or contact lenses ....A refractor or phoroptor holds a variety of lens strengths to test your vision." 

The criteria for classifying healthcare organizations comprised of descriptors attributed to a company

Healthcare organizations are classified by the following criteria: total number of facility beds, utilization, finances, and staffing.

The value in arm’s-length transactions, consistent with general market value, without taking into account any ability between parties to refer business to each other.

The price that would be received to sell an asset or paid to transfer a liability (an exit price) in an orderly transaction between market participants at the measurement date.

“[A] view as to whether the consideration offered in a deal is within the range of what would be considered ‘fair.’”

The payment system agreed upon between consultant and client based on the amount of time and resources an engagement requires and its profitability for the consultant. Generally flat fees and hourly rates are used for consulting.

A payment policy under which providers receive a fee for each service provided (e.g., an office visit, test, procedure, etc.).

A fee schedule is a payment system under which the fees for procedures are explicitly laid out and the physician agrees to accept those fees as full payment unless the discounted charges are less than the fee schedule; in which case the plan pays the lesser of the two.

A payment policy under which providers receive a fee for each service provided (for example, an office visit, test, procedure, etc.).

A method of financial analysis that may be used to understand the operational and financial status of a healthcare organization. Financial benchmarking consists of three steps (1) historical subject benchmarking, (2) benchmarking to industry norms, and, (3) financial ratio analysis.

Liability that assigns responsibility for any debt accrued by the practice.