Glossary

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Click one of the letters above to be taken to a page of all terms beginning with that letter.

Economy of scale: The decrease in the unit cost of a product that results from large-scale production.
Effectiveness: The degree to which health care is provided in the correct manner, given the current state of knowledge, to achieve the desired or projected outcome(s) for the patient.
Efficacy: The extent to which medical interventions achieve health improvements under ideal circumstances.
Efficiency: The relationship between the outcomes (results of health care) and the resources used to deliver care.
Elasticity: In economics, a ratio of the percent change in one variable (for example, demand for a service) to a percentage change in another variable (for example, price).
Electronic Health Record / Electronic Medical Record: The terms EHR and EMR are often used interchangeably. An EMR is an electronic equivalent of a paper-based medical record maintained by providers for patients. An EHR is an EMR that draws information from multiple clinical and administrative data sources and is accessible by multiple providers.
Eligibility: Whether an individual is entitled to receive specific benefits, or is covered at all, under a given insurance plan, governmental program, or other health care plan.
Employee Retirement Income Security Act of 1974: The Employee Retirement Income Security Act, Pub. Law No. 93-406 (1974) mandates reporting and disclosure requirements for pension and employee benefit plans, with relevant guidance on the sponsorship, administration, minimum record-retention period, servicing of plans, some claims processing, appeals regulations, and minimum mandatory clinical benefits. Through a complicated scheme of clauses, ERISA pre-empts state health insurance regulation of self-insured employers.
Employer contribution: The portion of the health care premium that is the responsibility of the employer; its size may vary based on tenure or family status, or other factors that may be stipulated by the employer.
Employer mandate: Under an employer mandate policy, all or some subset of employers would be required by law to offer health insurance to all or some subset of their employees. Employer-mandate proposals often include a "pay-or-play" provision—which means that employers may choose to offer health insurance to their employees (the "play" option) or pay a fee or tax into a public fund that is used to cover uninsured workers (the "pay" option).
Employer-sponsored health insurance: Generally refers to health insurance coverage provided through an individual's employment (in contrast to individual health insurance, which is purchased without the employer as an intermediary).
End-stage renal disease: The final stage of kidney failure (such as that resulting from diabetes, chronic hypertension, or glomerulonephritis), which is marked by the complete or nearly complete irreversible loss of renal function.
Episode: The entire course of treatment for a particular health care problem or procedure typically ranging from a few days for self-limiting conditions, such as colds, to a year for chronic conditions.
Equity: The absence of avoidable or remediable differences in quality of care among populations or groups defined socially, economically, demographically, or geographically.
Evidence-based Medicine: Refers to using the best available information from scientific studies and other sources (e.g., professional consensus) to recommend a specific course of medical intervention for a particular patient.
Excellus/Rochester Individual Practice Association: Excellus/Rochester Individual Practice Association (RIPA) is a program that provides doctors with performance reports to help improve patient care via measures of quality, affordability, and satisfaction. Excellus/RIPA has been used to improve the management of patients with sinusitis, otitis, diabetes, asthma, and heart disease, and it has identified a return on investment under P4P.
Exception reporting: A situation in which a physician would exclude from reporting those patients whose poor health behavior and/or health status might adversely affect clinical indicator scores (for example, patients who do not take prescribed medication or for whom a medication cannot be prescribed due to a contraindication).
Experience rating: The most common method of determining premiums of health insurance in which rates are based partly or wholly on the previous claims experience of various groups and subgroups of subscribers, members, or beneficiaries - and then required revenues for a future policy year for a specific group or pool of groups are projected.
Experimental design: A planned method of collecting data under controlled conditions. An experiment deliberately imposes a treatment or intervention on one group of subjects (randomly assigned to receive the experimental treatment) so that the response may be may be assessed (as compared to the response of a group of control subjects who did not receive the treatment).

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