Delaware Healthcare Association
Glossary of Health Care Terms
and Acronyms

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DISCLAIMER

The definitions listed here are intended for a general understanding of a health care term. These definitions should not be considered as the complete definition, since many are written in the simplest form to give a general understanding of the term listed.

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.

Alphabetical Listing

A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z

Acronyms

A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z

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Occupancy Rate A measure of inpatient health facility use, determined by dividing available bed days by patient days. It measures the average percentage of facilities' beds occupied.
Occupational Safety and Health Administration (OSHA) A Federal agency within the U.S. Department of Labor that is responsible for setting standards to promote and enforce employee safety in the workplace.
Occupational Therapist (OT) Occupational therapists assess functioning in activities of everyday living, including dressing, bathing, grooming, meal preparation, writing, and driving, which are essential for independent living. In making treatment recommendations, the OT addresses (1) fatigue management, (2) upper body strength, movement, and coordination, (3) adaptations to the home and work environment, including both structural changes and specialized equipment for particular activities, and (4) compensatory strategies for impairments in thinking, sensation, or vision.
Off-Open Enrollment Termination See attrition rate.
Office of Inspector General (OIG) of the U.S. Department of Health and Human Services The enforcement arm within the U.S. Department of Health and Human Services that oversees investigations of alleged violations of Medicare and Medicaid laws and rules.
Office of Management and Budget (OMB) A Federal agency responsible for providing fiscal accounting and budgeting services for the Federal government.
Office of Personnel Management (OPM) Among other things, the Federal agency that administers and directs all Federal Employee Health Benefits Programs.
Office of Professional Standard Review Organizations The health standards and quality bureau of the Health Care Financing Administration.
Older Americans Act (OAA) 1965 Federal legislation to create a network of state and area agencies on aging. These agencies help plan and fund programs and services for persons over the age of sixty.
Omnibus Budget Reconciliation Act (OBRA) An amendment to the Federal budget that outlines new Federally funded programs or revisions to existing programs. In 1985, the amendment was called the Consolidated Omnibus Budget Reconciliation Act, or COBRA.
Open Access Allows members to see participating providers, usually a specialist, without a referral from the health plan's gatekeeper. These types of arrangements are most often found in IPA-model HMOs.
Open Enrollment If an employer offers the covered population two or more options in selecting health benefits coverage, there is usually an annual period of time within which the employee can make changes in the coverage previously selected. Changes might include an increase in out-of-pocket expenditures to reduce personal premium participation or a change from indemnity insurance toHMO or PPO coverage.
Open Enrollment Termination See attrition rate.
Open Ended HMO See Point of Service Plan.
Open Panel HMO An HMO in which any licensed physician in an area is eligible to join the HMO. An individual practice association is an example of an open panel plan.
O.R. Tech Assists the surgical team during operative procedures. Includes acting as scrub nurse and circulating nurse, assists in preparing patient for surgery, transports patient from O.R. to recovery, assists in clean up of operating theatre, counts sponges, needles and instruments used during surgery.
Organ Procurement Organization (OPO) A non-profit Federally funded organization that has many responsibilities in the organ transplantation process.
Organized Delivery System A comprehensive, integrated network of providers who manage and deliver many levels of care in comprehensive set of health services.
ORYX The integration of performance measurement into the Joint Commission's accreditation process. Each accredited facility must select vendors that have been approved by the JCAHO for the performances measurement system.
Osteopathic A school of medicine that uses manipulative measures in treating patients in addition to the diagnostic and therapeutic measures of medicine. The other school is allopathic.
Out-Of-Area Benefits The coverage allowed to HMO members for emergency and other situations outside of the prescribed geographic area of the HMO.
Out of Network Services received from a provider who does not participate with the enrollee's health plan. See point of services, and freedom of choice.
Out of Plan  See out of network.
Out-Of-Pocket Expenses or Costs The share of health services payments paid by the enrollee.
Out-Of-Pocket Maximum or Cap An annual limit on how much in deductibles and co-payments the patient is required to pay. Also called "stop-loss" provision.
Outcome and Effectiveness Research Medical or health services research that attempts to identify the clinical outcomes of the delivery of health care.
Outcome Audit A type of patient/medical care evaluation study in which criteria are designed to focus upon desired patient outcome or results of treatment, as distinguished from a process audit in which criteria focus upon the components of appropriate clinical intervention.
Outcome Management Collecting and analyzing results of medical performance and using that information to optimize healthcare results.
Outcome Measures Assessments to gauge the results of treatment for a particular disease or condition. Outcome measures include the patient's perception of restoration of function, quality of life and functional status, as well as objective measures of mortality, morbidity and health status.
Outcomes and Assessment Information Set (OASIS) Federal monitoring system for Home Health Agencies.
Outcomes Research Research on the effects on health, function, or quality of life of the patient resulting from various health services or from ways of organizing and financing health services.
Outlier A comparative term describing a patient whose stay in the hospital is unusually long or whose costs for hospital care are unusually high compared to other patients with the same diagnosis or condition. The Medicare program uses DRGs as categories to identify outliers. Under Medicare, additional payments are made for outliers meeting certain conditions.
Outpatient A person who receives health care services without being admitted to a hospital.
Outpatient Services Medical and other services provided by a qualified facility where an overnight stay is not required, such as therapy and other clinics, labs and diagnostic centers. Seeinpatient services, and ambulatory care.
Outside Referral Referral to a consultant provider not on the managed care company's staff or within its network of providers.
Over The Counter Drugs A drug that does not require a prescription.
Overvalued Procedure A procedure for which the payment rate has been reduced because it was identified as "overvalued" under the customary, prevailing, and reasonable payment system.