Regulatory & Compliance
This federal agency oversees Medicare, Medicaid, and national health‑care quality programs.
Centers for Medicare & Medicaid Services (CMS)
This Medicare payment system assigns values to physician services and determines reimbursement amounts.
Medicare Physician Fee Schedule (MPFS)
This term refers to non‑physician clinicians such as nurse practitioners and physician assistants.
Advanced Practice Provider (APP)
This financial metric reflects operating performance before the effects of financing and non-cash expenses.
Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA)
This investigative process examines financial, legal, and operational risks before a transaction.
Due Diligence
This law protects patient health information and sets national privacy and security standards.
Health Insurance Portability and Accountability Act (HIPAA)
This outpatient payment system groups services based on clinical similarity and resource use.
Ambulatory Payment Classification (APC)
This facility type provides same‑day surgical care without requiring hospital admission.
Ambulatory Surgery Center (ASC)
This term refers to the distribution of patients covered by different insurance types.
Payer Mix
The price at which an asset would change hands between a willing buyer and seller in an open market.
Fair Market Value (FMV)
This law prohibits physicians from referring Medicare patients to entities with which they have a financial relationship.
Stark Law
This inpatient payment methodology reimburses hospitals based on standardized patient categories.
Diagnosis-Related Group (DRG)
This designation supports rural hospitals with 25 or less acute care beds to improve access to care.
Critical Access Hospital (CAH)
This revenue measure captures income earned from direct patient care services.
Net Patient Service Revenue (NPSR)
This analysis evaluates the sustainability and accuracy of a company’s reported earnings.
Quality of Earnings (QoE)
This criminal statute bans offering or receiving anything of value to influence federal health‑care program referrals.
Anti-Kickback Statute
This code set describes medical, surgical, and diagnostic services. Widely used by clinicians, coders, and payers.
Current Procedural Terminology (CPT)
This model of care emphasizes collaboration among providers, patients, and their families.
Patient- and Family-Centered Care (PFCC)
This profitability ratio measures income earned from operations relative to total revenue.
Operating Margin
This preliminary agreement outlines key deal terms before drafting a final contract.
Letter of Intent (LOI)
This law requires hospitals to provide emergency screening and stabilizing treatment regardless of a patient’s ability to pay.
Emergency Medical Treatment & Labor Act (EMTALA)
This coding system includes supplies, equipment, and services not captured by CPT codes.
Healthcare Common Procedure Coding System (HCPCS)
This national survey measures patient experience and publicly reports hospital performance.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
This metric reflects the complexity and resource needs of a hospital’s patient population.
Case Mix Index (CMI)
This business valuation method determines an asset or company's value by comparing it to similar, recently sold assets or publicly traded peers.
Market Approach