| Western Section: | Midwest Section: | Eastern Section: | Southern Section: |
|---|---|---|---|
| Alaska | Illinois | Connecticut | Alabama |
| Arizona | Indiana | Delaware | Arkansas |
| California | Iowa | District of Columbia | Florida |
| Colorado | Michigan | Maine | Georgia |
| Hawaii | Minnesota | Maryland | Kansas |
| Idaho | Nebraska | Massachusetts | Kentucky |
| Montana | North Dakota | New Hampshire | Louisiana |
| Nevada | Ohio | New Jersey | Mississippi |
| New Mexico | South Dakota | New York | Missouri |
| Oregon | Wisconsin | North Carolina | Oklahoma |
| Utah | Pennsylvania | South Carolina | |
| Washington | Rhode Island | Tennessee | |
| Wyoming | Vermont | Texas | |
| Virginia | |||
| West Virginia |
Health and Human Services (HHS) Regions
| HHS Region 1: | HHS Region 2: | HHS Region 3: | HHS Region 4: | HHS Region 5: |
|---|---|---|---|---|
| Connecticut | New Jersey | Delaware | Alabama | Illinois |
| Maine | New York | District of Columbia | Florida | Indiana |
| Massachusetts | Maryland | Georgia | Michigan | |
| New Hampshire | Pennsylvania | Kentucky | Minnesota | |
| Rhode Island | Virginia | Mississippi | Ohio | |
| Vermont | West Virginia | North Carolina | Wisconsin | |
| South Carolina | ||||
| Tennessee | ||||
| HHS Region 6: | HHS Region 7: | HHS Region 8: | HHS Region 9: | HHS Region 10: |
| Arkansas | Iowa | Colorado | Arizona | Alaska |
| Louisiana | Kansas | Montana | California | Idaho |
| New Mexico | Missouri | North Dakota | Hawaii | Oregon |
| Oklahoma | Nebraska | South Dakota | Nevada | Washington |
| Texas | Utah | |||
| Wyoming |
Lead in Position
An individual who is considered a lead in the position, demographic in nature.
Legal Organization
Business Corporation: A for-profit organization recognized by law as a business entity separate and distinct from its shareholders. Shareholders need not be licensed in the profession practiced by the corporation.
Limited Liability Company: A legal entity that is a hybrid between a corporation and a partnership, because it provides limited liability to owners like a corporation while passing profits and losses through to owners like a partnership.
Not-For-Profit Corporation/Foundation: An organization that has obtained special exemption under Section 501(c) of the Internal Revenue Service code that qualifies the organization to be exempt from federal income taxes. To qualify as a tax-exempt organization, a practice or faculty practice plan would have to provide evidence of a charitable, educational, or research purpose.
Partnership: An unincorporated organization where two or more individuals have agreed that they will share profits, losses, assets, and liabilities, although not necessarily on an equal basis. The partnership agreement may or may not be formalized in writing.
Professional Corporation/Association: A for-profit organization recognized by law as a business entity separate and distinct from its shareholders. Shareholders must be licensed in the profession practiced by the organization.
Sole Proprietorship: An organization with a single owner who is responsible for all profit, losses, assets, and liabilities.
Medical Records Storage System
The method in which the practice stored health/medical records for the majority of patients served by the practice.
Minor Geographic Region
| Northeast: | Southeast: | Lower Midwest: |
|---|---|---|
| Connecticut | Alabama | Arkansas |
| Maine | Florida | Kansas |
| Massachusetts | Georgia | Louisiana |
| New Hampshire | Mississippi | Missouri |
| Rhode Island | North Carolina | Oklahoma |
| Vermont | South Carolina | Texas |
| Tennessee | ||
| North Atlantic: | Eastern Midwest: | Rocky Mountain: |
| New Jersey | Illinois | Arizona |
| New York | Indiana | Colorado |
| Pennsylvania | Kentucky | Montana |
| Michigan | Nevada | |
| Ohio | New Mexico | |
| Utah | ||
| Wyoming | ||
| Northwest: | Upper Midwest: | Pacific: |
| Idaho | Iowa | Alaska |
| Oregon | Minnesota | California |
| Washington | Nebraska | Hawaii |
| North Dakota | ||
| South Dakota | ||
| Wisconsin | ||
| Mid Atlantic: | ||
| Delaware | ||
| District of Columbia | ||
| Maryland | ||
| Virginia | ||
| West Virginia |
Number of FTE Advanced Practice Providers
The practice's full-time-equivalent (FTE) advanced practice provider count. For further detail on FTE or Advanced Practice Providers, see corresponding definitions.
- No advanced practice providers
- 3 or fewer
- 4 to 9
- 10 or more
Number of FTE Physicians
The practice's full-time-equivalent (FTE) physician count. For further detail on FTE, see Full-Time Equivalent above.
- 6 or fewer
- 7 to 10
- 11 to 25
- 26 to 50
- 51 to 75
- 76 to 150
- 151 or more
Number of FTE Physicians (expanded)
The practice's full-time-equivalent (FTE) physician count. For further detail on FTE, see Full-Time Equivalent above.
- 3 or fewer
- 4 to 6
- 7 to 10
- 11 to 25
- 26 to 50
- 51 to 75
- 76 to 150
- 151 or more
Number of FTE Providers
The practice's full-time-equivalent (FTE) provider count. For further detail on FTE or providers, see corresponding definitions.
- 10 or fewer
- 11 to 25
- 26 to 50
- 51 to 100
- 101 to 150
- 151 or more
Number of Support Staff
The practice’s total support staff FTE including business operations staff, front office support staff, clinical support staff, ancillary support staff, and contracted support staff.
- No support staff
- 3 or fewer
- 4 to 9
- 10 or more
Organization Ownership
Hospital/IDS Owned:
- Hospital: A hospital is an inpatient facility that admits patients for overnight stays, incurs nursing care costs, and generates bed-day revenues.
- Integrated Health System or Integrated Delivery System (IDS): A network of organizations that provide or coordinate and arrange for the provision of a continuum of health care services to consumers and is willing to be held clinically and fiscally responsible for the outcomes and the health status of the populations served. Generally consisting of hospitals, physician groups, health plans, home health agencies, hospices, skilled nursing facilities, or other provider entities, these networks may be built through “virtual” integration processes encompassing contractual arrangements and strategic alliances as well as through direct ownership.
- Management Services Organization (MSO): An entity organized to provide various forms of practice management and administrative support services to health care providers. These services may include centralized billing and collections services, management information services, and other components of the managed care infrastructure. MSOs do not actually deliver health care services. MSOs may be jointly or solely owned and sponsored by physicians, hospitals, or other parties. Some MSOs also purchase assets of affiliated physicians and enter into long-term management service arrangements with a provider network. Some expand their ownership base by involving outside investors to help capitalize the development of such practice infrastructure.
- Physician Practice Management Company (PPMC): Publicly held or entrepreneurial directed enterprises that acquire total or partial ownership interests in physician organizations. PPMCs are a type of MSO, however their motivations, goals, strategies, and structures arising from their unequivocal ownership character – development of growth and profits for their investors, not for participating providers – differentiate them from other MSO models.
Physician Owned:
- Insurance company (including HMO and PPO): An insurance company is an organization that indemnifies an
insured party against a specified loss in return for premiums paid, as stipulated by a contract. An HMO is an
insurance company that accepts responsibility for providing and delivering a predetermined set of comprehensive
health maintenance and treatment services to a voluntarily enrolled population for a negotiated and fixed
periodic premium. - Advanced Practice Providers: Any advanced practice provider (e.g. nurse practitioners, physical therapists, etc.) duly licensed and qualified under the law of jurisdiction in which treatment is received.
- Privately Operated: A company or individual that takes their own money and uses it to fund another organization.
Some investors have the option to invest passively, which means they give their funding and play no further role,
while others have a more significant role in the organization. Includes non-clinical investors or owners. - Physicians: Any Doctor of Medicine (MD) or Doctor of Osteopathy (DO) who is duly licensed and qualified under the law of jurisdiction in which treatment is received.
- Foundation: Foundations are very similar to nonprofit legal entities to allow physicians, organizations or other
healthcare providers a mechanism to provide medical services or perform research. Foundations are generally
organizations that do not qualify as a public charity, but are often set up via an endowment to support charitable
purposes or as a memorial or similar healthcare related purpose. They are usually non-stock corporations and are
eligible for federal tax exempt status.
Other Majority Owner:
- Government: A governmental organization at the federal, state, or local level. Government funding is not enough criterion. Government ownership is the key factor. An example would be a medical clinic at a federal, state, or county correctional facility.
- University or Medical School: An institution of higher learning with teaching and research facilities comprising undergraduate, graduate and professional schools. A medical school is an institution that trains physicians and awards medical and osteopathic degrees.
Patient Care Revenue
The revenue received by the department from patient care activities, net of all refunds, returned checks, contractual discounts and allowances, bad debts and write-offs. The sum of total fee-for service (FFS) revenue, net prepaid (capitation/sub-capitation) revenue and net other patient care/ medical services revenue equals total patient care revenue.
- Net Prepaid (Capitation/Sub-Capitation) Revenue: A sum of all capitation revenue received from Health Maintenance Organizations (HMOs), risk-sharing revenue, hospital/utilization withholds, copayments and revenue received from a benefits coordination and/or reinsurance recovery situation minus professional and medical services purchased from outside providers.
- Net Other Patient Care/Medical Services Revenue: A sum of all revenue received from the sale of goods and services such as durable medical equipment rental, revenue from medical service contracts with nursing homes or ambulatory care centers, hospital reimbursements for direct patient care, and revenue from providing ancillary services on a fixed fee or percentage contract that are not billed as fee-for-service.
- Total FFS Revenue: A sum of net collections (receipts) from patients who are self-insured, or reimbursements from a third-party insurer that compensates the department (practice plan) on a fee-for-service, or discounted fee-for service basis.
Patient Centered Medical Home (PCMH)
A care delivery model where patient treatment and care is coordinated through their primary care provider to ensure they receive high quality care when care is necessary. The objective is collaboration between the patient and physicians with care delivered in a way the patient can understand. PCMHs seek to improve the quality, effectiveness, and efficiency of the care delivered while focusing on meeting patient needs first.
Practice Type
Multispecialty: A medical practice that consists of physicians practicing in different specialties.
Single Specialty: A medical practice that focuses its clinical work in one specialty. The determining factor for classifying the type of specialty is the focus of clinical work and not necessarily the specialties of the physicians in the practice.
Practice Type (Expanded)
Multispecialty: A medical practice that consists of physicians practicing in different specialties.
- Multispecialty with Primary and Specialty Care: Medical practices that consist of physicians practicing in different specialties, including at least one primary care specialty listed below:
- Family Medicine: General
- Family Medicine: Sports Medicine
- Family Medicine: Urgent Care
- Family Medicine: With Obstetrics
- Family Medicine: Without Obstetrics
- Geriatrics
- Internal Medicine: General
- Pediatrics: Adolescent Medicine
- Pediatrics: General
- Pediatrics: Sports Medicine
- Urgent Care
- Multispecialty with Primary Care Only: A medical practice that consists of physicians practicing in more than one of the primary care specialties listed above or one of the specialties below:
- Obstetrics/Gynecology
- Gynecology (only)
- Obstetrics (only)
- Multispecialty with Specialty Care Only: A medical practice that consists of physicians practicing in different specialties, none of which are the primary care specialties listed above.
Single Specialty: A medical practice that focuses its clinical work in one specialty. The determining factor for classifying the type of specialty is the focus of clinical work and not necessarily the specialties of the physicians in the practice.
Provider
Both physician and advanced practice providers (APP) that provide medical care and billable services. For more information on advanced practice providers, please see the corresponding definition.
Rural Health Clinic (RHC)
A clinic certified to receive special Medicare and Medicaid reimbursement. The purpose of the RHC program is to improve access to primary care in underserved rural areas. RHCs are required to use a team approach of physicians and advanced practice providers (nurse practitioners, physician assistants, and certified nurse midwives) to provide services. The clinic must be staffed at least 50% of the time with an advanced practice provider. RHCs may also provide other healthcare services, such as mental health or vision services, but reimbursement for those services may not be based on their allowable costs.
Total Medical Revenue
The sum of fee-for-service collections (revenue collected from patients and third-party payers for services provided to fee-for service, discounted fee-for-service, and non-capitated Medicare/ Medicaid patients), capitation payments (gross capitation revenue minus purchased services for capitation payments), and other medical activity revenues.
Net Prepaid (Capitation/Subcapitation) Revenue: Include all capitation revenue received from Health Maintenance Organizations (HMOs), risk-sharing revenue, hospital/utilization withholds, copayments and revenue received from a benefits coordination and/or reinsurance recovery situation minus professional and medical services purchased from outside providers.
Net Other Patient Care/Medical Services Revenue: Include all revenue received from the sale of goods and services such as durable medical equipment rental, revenue from medical service contracts with nursing homes or ambulatory care centers, hospital reimbursements for direct patient care, and revenue from providing ancillary services on a fixed fee or percentage contract that are not billed as fee-for-service.
Other Medical Revenue: includes grants, honoraria, research contract revenues, government support payments, and educational subsidies plus the revenue from the sale of medical goods and services.
Total Department Revenue: all revenue received by the department from patient care activities, net of all refunds, returned checks, contractual discounts and allowances, bad debts and write-offs. The sum of total fee-for-service (FFS) revenue, net prepaid (capitation/subcapitation) revenue and net other patient care/medical services revenue equals total patient care revenue.
Total FFS Revenue: Include net collections (receipts) from patients who are self-insured, or reimbursements from a third-party insurer that compensates the department (practice plan) on a fee-for-service, or discounted fee-for service basis.
Years of Experience
The total years of experience in the individual's current reported position.