Resource-Based Relative Value
A methodology determining physician reimbursement based on a standardised measure of resources required, incorporating work, practice expense, and malpractice risk.
Encyclopaedia
Explore comprehensive, evidence-informed explanations of key health economics concepts, including their development, application and relationships to other concepts. Published entries are validated through human expert review.
Retrospective Risk Adjustment
A risk adjustment method calculating payment adjustments after a coverage period ends, based on actual observed diagnoses and costs.
Risk Adjustment
A methodology adjusting payments to insurers or providers based on the health status and expected costliness of the population they cover.
Risk Corridor
A risk-sharing mechanism where government shares in an insurer's unexpectedly high losses or profits relative to a projected target, stabilising a new market.
Risk Pooling
Risk pooling is the health-financing process of combining prepaid funds so that the costs of healthcare are shared across members rather than borne entirely by individuals when they become ill.
Risk Score
A numerical value representing an individual's predicted relative healthcare cost, calculated using a risk adjustment model.
Sentinel Event Rate
A measure of the frequency of unexpected occurrences involving death or serious injury unrelated to a patient's underlying illness.
Slope Index of Inequality
A summary measure of absolute health inequality across a socioeconomic gradient, estimated using regression across the full distribution rather than two extremes.
Socioeconomic Adjustment
A modification to a risk adjustment or payment formula accounting for added costs of caring for socioeconomically disadvantaged populations.
Specific Stop-Loss
A reinsurance form protecting a self-insured employer against a single enrollee's claims exceeding a predefined threshold, unlike aggregate stop-loss.
SSI Rate
A measure of the frequency of surgical site infections following a procedure within a facility, a surgical infection prevention indicator.
Stop-Loss
Insurance coverage limiting a self-insured employer's maximum exposure by covering claims above a predefined threshold, individually or in aggregate.
Take-Up Rate
The proportion of individuals eligible for an insurance product or subsidy who actually enrol, assessing a coverage programme's effectiveness.
Throughput
A measure of the rate at which patients or units move through a healthcare process over a given period.
Trend Analysis
A statistical technique examining patterns of change in a variable over successive time periods, distinguishing direction from short-term fluctuation.
Years of Life Lost
A premature mortality measure calculated as the difference between age at death and a reference life expectancy, summed across deaths from a cause.