Departmental productivity can be compared with other hospitals. A system used by Medicare and some insurers to classify illnesses according to diagnosis and treatment. E conomies of Scale A decrease in unit costs because of the volume. A method of determining the premium for a health insurance policy based on the average cost of actual or anticipated utilization of care by various groups. F ederally Qualified HMOs HMOs that meet certain federally stipulated provisions aimed at protecting consumers, e.g., providing a broad range of basic health services, assuring financial solvency and monitoring the quality of care.
Patients pay doctors, hospitals and other health care providers for each service provided.
Most patients are reimbursed by the private insurer or the government. Critics charge that this arrangement leads to unnecessary care. Fee Schedule A list of accepted fees or predetermined monetary allowances for specified services and procedures. A type of benefits program offered by some employers whereby employees are presented with a menu of various benefit options from which they are allowed to tailor their benefits to their individual needs. The primary care provider responsible for managing medical treatment provided to an individual enrolled in a health plan.