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HOSPITALS/SYSTEMS DIGEST 2013
SANOFI / MANAGED CARE DIGEST SERIES
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/ WHERE INFORMATION BECOMES INTELLIGENCE.
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KEY TERMS
KEY TERMS
Accountable Care Organization (ACO):
An ACO is
an associated network of primary care physicians,
specialists and hospitals that actively coordinates the
delivery of care to effect higher quality outcomes.
ACOs report on quality measures, and the providers,
who likewise are accountable for maintaining a high
standard of individual performance, are rewarded
for their participation.
Acute Care:
Providing or concerned with short-term
medical care, especially for serious acute disease
or trauma.
Affordable Care Act (ACA):
The ACA was signed
into effect by President Obama in March 2010
as part of the administration’s comprehensive
health care reform legislation. The ACA is aimed
primarily at decreasing the number of uninsured
Americans, reducing the overall costs of health
care and improving quality. In June 2012, the
Supreme Court upheld the constitutionality of
most of the ACA, and many reforms have already
taken effect.
Average Length of Stay (ALOS):
The total number of
patient-days divided by the number of admissions
and discharges during a specified period of time,
which results in an average number of days in the
hospital for each person admitted.
Cancer Center:
A facility that offers an organized
program for the effective administration of cancer
treatment and related services. Outpatient
medical oncology treatment is the focal point
of care at the facility. This includes specialized
modes of cancer treatment such as radiation
oncology, chemotherapy/infusion therapy, or
medical/­surgical treatment.
Cardiac Care Unit (CCU):
A cardiac care unit treats
patients with serious heart conditions. Staff trained
and certified in heart conditions and related cardiac
procedures provide specialized care and extensive
heart monitoring.
Case Mix Index (CMI):
Severity is approximated
by the case mix index (CMI), which is a statistical
measure of the average amount of resources
consumed per Medicare inpatient case at a hospital.
Hospitals that tend to treat more resource-intensive
(i.e., severe) cases will have a higher calculated CMI.
Concomitant Diagnosis:
A secondary diagnosis,
occurring simultaneously, that accompanies a
diagnosis of the condition for which a patient is
admitted to a hospital or treated on an outpatient
basis, that may or may not be interrelated or
produced as a result of the primary diagnosis.
Diagnostic Imaging Center (DIC):
A facility that
provides diagnostic imaging and is physically
separate from a hospital or, if not physically separate,
is operated as an independent business. In the case
of multispecialty clinics, a significant portion of total
business must be done in diagnostic imaging.
Electronic Health Record (EHR):
The EHR is a complete
record of patient health information generated by
one or more encounters in any care delivery setting.
Patient demographics, progress notes, medications,
vital signs, past medical history, immunizations,
laboratory data and radiology reports are included.
The EHR automates and streamlines the clinician’s
workflow. A patient’s EHR can be accessible to
providers across various health settings.
For-Profit Hospital:
A hospital that is owned by an
individual, a partnership or a corporation that splits
profits among its shareholders.
Freestanding Outpatient Surgery Center (FOSC):
An independent medical facility designed and
equipped to handle surgery, pain management and
certain diagnostic procedures that do not require
overnight hospitalization.
Government Hospital:
A hospital that is owned by the
federal government (including military, Public Health
Service and Department of Justice) or a state, city or
county government.
Highly Integrated Health Care Systems:
Highly
integrated health care systems either own or contract
with at least three components of health care
delivery, including at least one acute-care hospital,
at least one physician component, and at least one
other component of care. Highly integrated health
care systems also have at least one systemwide
contract with a payer, such as an HMO.
Unless otherwise noted, all definitions are provided by IMS Health. (2012). Parsippany, NJ.
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