| OCR Text |
Show Prevalence The number of cases of disease, infected persons or persons with some other attribute, present at a particular time and in relation to the size of the population from which drawn. Provider Sponsored Network (PSN) Formal affiliations of providers, organized and operated to provide an integrated network of health care providers with which third parties, such as insurance companies, many contract for health care services to covered individuals. R Rate Band The allowable variation in insurance premiums as defined in state regulations. Acceptable variation may be expressed as a ration from highest to lowest or as a percent from the community rate. Usually based on risk factors such as age, gender, occupation or residence. Report Card A report presented on quality of health services designed to inform patients and health care purchasers of practitioner and organizational performance. Risk-Bearing Entity An organization that assumes financial responsibility for the provision of a defined set of benefits by accepting prepayment for some or all the cost of care. A risk-bearing entity may be an insurer, a health plan or self-funded employer, or a PHO or other form of PSN. S Severity of Illness A risk prediction system to correlate the "seriousness" of disease in a particular patient with the statistically "expected" outcome. Most effectively, severity is measured at or soon after admission, before therapy is initiated, giving a measure of pretreatment risk. T Telemedicine The use of telecommunications (i.e., wire, radio, optical, or electromagnetic channels transmitting voice, data and video) to facilitate medical diagnosis, patient care, and/or distance learning. Third-Party Payer Any organization, public or private, that pays or insures health or medical expenses on behalf of beneficiaries or recipients. An individual pays a premium for such coverage in all private and in some public programs; the payer organization then pays bills on the individual's behalf. U Utilization Review Evaluation of the necessity, appropriateness and efficiency of the use of health care services, procedures and facilities. In a hospital, this includes review of the appropriateness of admissions, services ordered and provided, length of a stay and discharge practices, both on a concurrent and retrospective basis. V Vertical Integration Organization of production whereby one business entity control or owns all stages of the production and distribution of goods or services. Utah's Health: An Annual Review 1996 125 |
