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Global budget

1. Method of cost containment in which the government places a ceiling or cap on total public and private health care expenditures for a specific population within a specified time period. This type of cost containment applies to expenditures by insurers and individuals. 2. In the hospital setting, a limit of total budget as a cost containment method in which participating hospitals share one projected budget and give out each hospital facility’s funds from that budget. Also called total budget .

Global capitation

Reimbursement method in which a managed care plan provides and pays for all health care services for an enrolled population of patients including physicians and hospitals. The plan accepts all risk for that population, which means it needs to keep costs for health care below the amount of premiums collected. A portion of the global cap may be withheld to pay for specialist care referred by primary care physicians. Each year excess funds may be either paid out or carried forward against future global capitation payments to the primary care physicians. Also called full-risk capitation, full-risk contract , or fully capitated .

Global excess/insurance

Reinsurance insurance covering all, or nearly all, of the reinsured’s business, i.e. ‘globally’ in ‘business spread’ and not ‘geographic’ terms. The ‘global’ pays losses in excess of the aggregate net aggregated losses sustained by the reinsured’s many departments (e.g. motor, aviation, marine, property, etc.) following one major event, such as Hurricane Betsey, that strikes simultaneously at ships, aircraft, property on land etc. Policy wording is similar to an excess of loss catastrophe reinsurance. ‘Globals’ can provide cover for specific risks as well as large risk accumulations.

Global fee

1. All-inclusive payment for hospital and physician services (e.g., a surgery case with all preoperative and postoperative medical care in one fee). 2. Combined technical (equipment) and professional (physician) charges or payment.

Global insurance programme

Worldwide programme enabling a multi-national to establish the same level of cover globally. It could consist of a master policy issued in the home country that results in a totally non-admitted insurance programme, i.e. no local policies. At the other extreme it is a totally admitted programme with all local entities being issued with policies and all premiums and losses being dealt with locally. Normally the programme entails: (a) a master policy arranged in the home country giving uniform cover for the whole group; and (b) local admitted policies reflecting local needs. The master policy tops up local policies to gain consistency across the group. The master policy is subject to a difference in conditions clause and a different in limits clause.

Global period

Specific period of time during which all medical services pertaining to a condition or diagnosis are considered included in the payment for the initial surgery or treatment and may not be billed separately. Complications related to the procedure are considered outside of the global period and not included in payment for the initial surgery or treatment. Medicare global surgical policy (GSP) is from 0 to 90 days postoperatively.

Global pricing

Reimbursement method in which both the hospital and physician fees are packaged into one price (global fee) for a specific medical procedure such as coronary artery bypass graft (CABG) surgery. In addition, the global fee often includes diagnostic procedures, postsurgical recovery, rehabilitation, and follow-up office visits within a certain time period. Also called package pricing and bundling .