Trust fund that has as its primary source of income payroll taxes paid by employees and employers. This fund finances hospital and medical services covered under Medicare Part A.

Cost of the mix of goods and services (including personnel costs but excluding nonoperating costs) comprising routine, ancillary, and special care unit inpatient hospital services. Also referred to as market basket .

Inpatient services besides daily room and board charges and general nursing services that are given during a hospital stay (e.g., laboratory tests, drugs, x-ray studies).

Number given to each member hospital facility by the managed care plan or insurance company for identification purposes.

Established by Centers for Medicare and Medicaid Services (CMS) to monitor and report the accuracy of Medicare fee-for-service (FFS) payments. The national error rate is calculated using a combination of data from the CERT contractor and HPMP with each component representing about 60% and 40% of the total Medicare FFS dollars paid. The CERT program measures the error rate for claims submitted to carriers, durable medical equipment regional carriers (DMERCs), and fiscal intermediaries (FIs). The HPMP measures the error rate for the quality improvement organizations (QIOs). Beginning in 2003, CMS elected to calculate a provider compliance error rate in addition to the paid claims error rate. The provider compliance error rate measures how well providers prepare Medicare FFS claims for submission. CMS calculates the Medicare FFS error rate and estimate of improper claim payments using a methodology the Office of the Inspector General approved. The CERT methodology includes randomly selecting a sample of approximately 120,000 submitted claims, requesting medical records from providers who submitted the claims, and reviewing the claims and medical records for compliance with Medicare coverage, coding, and billing rules.

Payment to a facility for the health services given to treat an inpatient.

State-licensed physicians with privileges to admit patients for treatment and medical services. May sometimes be referred to as organized staff or medical staff .

In 1913, the year of its founding, the American College of Surgeons appointed Codman to chair a committee on hospital standardization and to establish the College’s standardization program. This endeavor represents an integral part of the College’s history because it evolved into the Joint Commission on Accreditation of Hospitals in 1951 and the Joint Commission on Accreditation of Healthcare Organizations in 1987.