A set of mechanisms that ensure patients and clinicians have access to, and take into consideration, all required information on a patient’s conditions and treatments to ensure that the patient receives appropriate health care services.
A flat amount paid out of pocket per medical service, for example $5 per office visit. (Contrast with coinsurance, which is stated as a percentage, for example 10 percent of the total charge up to a specified maximum.)
Specific clinical measures that, when viewed together, permit a robust assessment of the quality of care provided in a given focus area, such as acute myocardial infarction.
Any out-of-pocket payment the patient makes for a portion of the costs of covered services. Deductibles, coinsurance, copayments and balance bills are types of cost sharing.
The practice by which a seller of a health service, such as a hospital, increases charges for some payers to offset losses due to uncompensated or indigent care or lower payments from other payers.