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To look up a health care term such as Actuary, choose the letter that the term begins with below under Alphabetical Glossary. This will take you to the terms beginning with that letter. To look up a health care acronym such as AIDS, choose the letter that the term begins with below under Acronyms. This will take you to all acronyms that begin with that letter.

Daily Benefit Amount	In a long-term care policy the specific amount of insurance the policy pays for each covered day of long term care as defined in the policy. The enrollee may choose from a wide range of daily benefit amounts and, under some policies, different amounts for different types of care, such as a higher daily benefit for nursing home care and a somewhat lower benefit for home care.
Data Book	See actuary.
Data Base, Health Care	See health care database.
Day Outlier	In Medicare, this refers to a patient with an atypically long length of stay compared with other patients in a particular diagnosis related group. Also seecost outlier.
Death Benefit	In some long-term care policies, a benefit payable to the enrollee's survivors or estate if the enrollee dies before a specified age, often 65 or 70. The benefit amount is a refund of premiums the enrollee paid minus the amount of any benefits the enrollee received while living.
Decision Making Capacity and Incapacity	Decision making capacity is typically defined under state law as the ability of a patient to understand and appreciate the nature and consequences of health care decisions and to make an informed choice. If a person loses this ability, he or she is said to be incapacitated; and if a court determines that a person has become incapacitated, he/she is referred to as being legally incompetent.
Decision Tree	The fundamental analytic tool for decision analysis, is a way of displaying the temporal and logical sequence of a clinical decision problem. Its form highlights tree structural components: The alternative actions that are available to the decision maker; the probabilistic events that follow from and affect these actions, such as clinical information obtained or the clinical consequences revealed; and the outcomes for the patient that are associated with each possible scenario of actions and consequences.
Decretion	Termination of membership in a Medicare HMO; always the last day of the month.
Deductible	Required out-of-pocket expenditure by the covered individual before the insurer pays towards the allowable charges for a covered service. Deductibles may be specified in dollar amounts or units of service.
Deductible, Leveraging Effect	A component of the insurance premium of "fixed" deductibles upon the price increase for a group medical plan. While premiums generally increase from one policy year to the next, employee-paid deductible usually remain constant or "fixed." If insurance claims increase while the deductible remains the same between one policy year and the next, an economic adjustment is made in the premium structure to reflect the increase in the cost of the amount of benefits paid in comparison to increases in the total cost of services. Fixed deductibles result in greater inflation in group premiums that the underlying trend in medical care costs. The larger the deductible, the greater the impact on premium inflation the following policy year.
Defensive Medicine	Physician practices solely to reduce risk of a liability claim (e.g., performing diagnostic test of marginal value).
Deficit Reduction Act of 1984 (DEFRA)	Federal law with a number of implications, including the provision that requires companies to give employee spouses over 65 the opportunity to enroll under employer group health plans.
Defined Contribution Coverage	A funding mechanism for health benefits whereby employers make a specific dollar contribution toward the cost of insurance coverage for employees, but make no promises about specific benefits to be covered.
Deinstitutionalization	Policy which calls for the provision of supportive care and treatment for medically and socially dependent individuals in the community rather than in an institutional setting.
Delaware Healthcare Association	A statewide membership services organization that exists to represent and serve hospitals, health systems, and related health care providers in their role of providing a continuum of appropriate, cost-effective quality care to improve the health of the people of Delaware. The primary role of the Association is to serve as a leader in the promotion of effective change in health services through collaboration and consensus building on health care issues at the State and Federal levels. Based in Dover, DE.
Demand Management	A variety of strategies to reduce utilization of health care services such as telephone health help lines, intended to prevent unnecessary use of medical services. Also used to describe educational programs designed to teach patients about their medical conditions which results in better patient self management and the utilization of fewer health care resources in the long term.
Dependent	An individual who receives health insurance through a spouse, parent, or other family member.
Depth of Benefits or Coverage	Refers to the level of patient cost sharing required under a health insurance plan.
Developmental Disability (DD)	A severe, chronic disability which is attributable to a mental or physical impairment or combination of mental and physical impairments; is manifested before the person attains age 22; is likely to continue indefinitely; results in substantial functional limitations in three or more of the following areas of major life activity: self-care, receptive and expressive language, learning, mobility, self-direction, capacity of independent living, economic self-sufficiency; and reflects the person's needs for a combination and sequence of special, interdisciplinary, or generic care treatments of services which are lifelong or extended duration and are individually planned and coordinated.
Diagnostic Guidelines	A practice guideline targeted at evaluating patients with particular symptoms for the presence of diseases that would benefit from intervention. They are also used to guide the screening of asymptomatic patient populations for early stages of disease.
Diagnostic Related Group (DRG)	A hospital classification system that groups patients by common characteristics requiring treatment.
Diagnostic Related Group (DRG) Creep	The illegal practice of manipulating and relabeling case mix into a higher reimbursement group.
Differential	The out-of-pocket (or payroll deduction) difference that an eligible individual may be required to pay.
Direct Access	See self referral.
Direct Contracting	Providing health services to members of a health plan by a group of providers contracting directly with an employer, thereby cutting out the middleman or third party insurance carrier. The provider is usually at full risk in this situation.
Direct Contract HMO	An HMO that contracts with each participating physician directly.
Direct Cost	Costs that are wholly attributable to the service in question, for example, the services of professional and paraprofessional personnel, equipment, and materials.
Direct Spending on Health	The amount directly paid for health insurance premiums by a household, as well as other out-of-pocket expenses for health care services.
Directly Financed Services	Public health care and related social services (often funded by Federal, State and local governments) that are targeted towards the underserved and uninsured populations. They include public hospitals/clinics, Community and Migrant Health Centers, Health Care for the Homeless, and a variety of other grant and appropriations programs.
Disability	As defined by the World Health Organization, a disability (resulting from an impairment) is a restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being.
Discharge Planning	Services offered by health care facilities prior to discharge to help patients and their families develop an appropriate plan for post-discharge care.
Disclaimer	A qualifying statement. For example, a notice that while a statement may be generally true, there are exceptions.
Discounted Fee-For-Service	An agreed upon rate for service that is usually less than the provider's full fee. This may be a fixed amount per service, or a percentage discount. Providers generally accept such contracts because they represent a means to increase their volume or reduce their chances of losing volume. Also see preferred provider organization or exclusive provider organization.
Disease Management	An effort to improve patient outcomes and lower costs by organizing managed care initiative around patients with a particular disease or condition.
Disenrollment	Terminating coverage with a health plan or insurance. Also see enrollment.
Disproportionate Share	Refers to providers who serve a disproportionately high percentage of low-income, uninsured, or otherwise underserved patients.
Disproportionate Share Hospital (DSH)	A hospital that provides care to a high number of patients who cannot afford to pay and/or do not have insurance.
Do Not Resuscitate (DNR)	An advance directive that patients may make to forego cardiopulmonary resuscitation or other resuscitative efforts (see advance directive).
Doctor of Osteopathy (DO)	A licensed physician who is a graduate from an accredited school of osteopathic medicine.
Domestic Insurance Company	An insurance company that operates under the laws of a specific state.
Domicillary Care	Residential program of the Veterans Administration providing health and social services to ambulatory disabled veterans. Generally involves less intensive care than a skilled nursing facility, but more than independent living.
Double Indemnity	Payment of twice the policy's normal benefit in case of loss resulting from specified causes or under specified conditions.
Drug Formulary	A listing of prescribed drugs covered by an insurance plan or used within a hospital. A positive formulary lists eligible products while a negative one lists exclusions. Some insurers will not reimburse for prescribed drugs not listed on the formulary; others may have limited reimbursement for non-formulary drugs.
Drug Maintenance List	A catalog of a limited number of prescription medications, as designated by a managed health care organization, commonly prescribed by health care providers for their long-term patient use. This list is usually modified on a regular basis. Also referred to as an additional drug benefit list.
Drug Price Review	A monthly update of drug prices, at average wholesale price, from the American Druggist Blue Book.
Drug Use Evaluation (DUE)	An evaluation of prescribing patterns of physicians to specifically determine the appropriateness of drug therapy. There are three forms of DUE: Prospective (before or at the time of prescription dispensing), concurrent (during the course of drug therapy), and retrospective (after the therapy has been completed).
Drug Utilization Review	An evaluation of prescribing patterns or targeted drug use to specifically determine the appropriateness of drug therapy.
Dual Eligible	A person enrolled in Medicare and Medicaid.
Duplicate Coverage Inquiry	A request to an insurance company or group plan by another insurance company or plan to determine whether other coverage exists for purposes of coordination of benefits.
Duplication of Benefits	Overlapping or identical coverage of an insured person under two or more health plans, usually the result of contracts with different insurers.
Durable Medical Equipment (DME)	Equipment that can stand repeated use, is primarily and customarily used to serve a medical purpose, it generally is not useful to a person in the absence of illness or injury, and is appropriate for use at home, such as hospital beds, wheelchairs, and oxygen equipment.
Durable Power of Attorney	A document in which competent individuals can select other individuals to make decisions, including health care decisions, for them in the event they become incapacitated.