R

Resource-based Relative Value Scale

A formula that determines set Medicare payments for physician services using inputs of the resources used (physician work, the cost of providing the service, and liability) and adjusted for geographic differences.

Resource Utilization Group (RUG)

A payment system under Medicare for skilled nursing facilities.

Return on Investment (ROI)

Refers to when an investment produces a profit to an investor and is used to show the efficiency of an investment of a group of different investments.

Return to Work Provision

Various provision and incentives designed to encourage employees to return to their jobs as soon as it is safe for them to do so.

Risk

Ultimate monetary responsibility for either profits or losses associated with health care.

Risk Adjustment

Increasing or decreasing payments as the expected spending or level of care needed changes.

Risk Corridor

Provision designed to manage unpredictability in the insurance market. Plans with lower than anticipated costs are required to pay a portion of their savings into a fund designated to help plans with higher than anticipated costs.

Allowable Charge

An approved bill from a health care provider to an insurance company.