DOCSLIB.ORG

Glossary Cf Health Coverage and Medical Terms

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Glossary Cf Health Coverage and Medical Terms Glossary cf Health Coverage and Medical Terms r This glossary has many commonly used terms, but isn't a full lisl These glossary terms and definitions are intended to be educational and may be different from the terms and definitions in your plan. Some of these terms also might not have exacdy the same meaning when used in your policy or plan, and in any such case, the policy or plan governs. (See your Summary of Benefits and Coverage for information on how to get a copy of your policy or plan document.) . Berld blue text indicates a terrn defined in this Glossary. I See page 4 for an example showing how deductibles, cc-instrance and out-of-pocket limix work togerher in a real life situation. Allowed Amount Co-palznerrt Maximum amount on which payment is based for A fixed amount (for example, $I5) you pay for a covered covered health care seryices. This may be called "eligible health care service, usually when you receive the service. expense," "payment allowancett or "negotiated rate.tt If The amount can vary by the type of covered health care your ptovider charges more chan che allowed amount, you service. may have to pay the difference. (See Bala*ce Bi[iog.) Deductible App.rl The amount you owe for :o A requesc for yoor health insurer or plan to review a health care services your decision or a grievance again. health irx*ranee or plan covers before your healrh Balance Billing insurance or plan begins pavs Hcr plan pavs When a prt:vider bills you for the difference between the to pay. For example, if lirnc o% provider's charge and the aliowed amount. For example, your deductible is $I000, r00% if che provider's charge is $I00 and the allowed amounr your plan won't pay i.Sct' ;,agc 4 lbr a Jr:taibd rr.rnrplc, i is $70, the provider may bill you for the remaining $30. anything until you've met A prefrrred prcvid* may notbalance bill you for covered your $ 1000 deductible for covered healch care services services. subject to the deduccible. The deductible mav nor apply to all services. Co-insurance Your share of the costs Drrable Medical Equipment (DI!C) ofa covered health care Equipment and supplies ordered by a health care provider service, calculated as a for cveryday or extended use. Coverage for DME may percent (for example, include: oxygen equipment, wheelchairs, crutches or 20%) of the atrlowed blood testing strips for diabetics. afirou{lf for the service. |ane pirvs Hr:r pl:rn pavs You co-insurance pay 2Ao/o 8}o/o Emergency Mefical Confition plusany deductibles i,Scc pagc -1 ibr .r .1i:rai[cd cr,rr,plc.) An illness, injury, symptom or condition so serious rhat a you owe. For example, reasonable person would seek care right away to avoid if the health insuracre or plan's allowed amount for an severe harm. office visit is $I00 and you've met your deductible, your co-insurance payment of 20o/o would be $20. The healch Emergency Medical Transportation insurance or plan pays the rest of the allowed amount. Ambulance services for an ex:rrgency me<{ieal conetrition. Complications of Pregnancy Emetgency Room Care Conditions due to pregnancy,labor and delivery that Yrx*zg*nc'V seryices you get in an emergency room. require medical care to prevent serious harm to the health of the mother or the fetus. Morning sickness and a non- Emergency Services emergency caesarean seccion aren't complications of Evaluation of an ernergency medical condition and Pregnancy. treatment to keep the condition from getting worse. OMB Control Numbers 1545-2229, 1210-0147, and 0938-l 146 Glossary of Hrakh Coverage and Medical Terms Page 1 of 4 Exduded Services Medically Necessary Health care services that your health insurance or plan Health care seryices or supplies needed to prevent, doesn't pay for or cover. diagnose or treat an illness, injury, condition, disease or its sympcoms and that meet accepred standards of C,rievance medicine. A complaint that you communicate to your health insurer or plxr. Network The facilities, providers and suppliers your health insurer Habilitation Services or pla* has contracted with to provide health care Health care services char help a person keep, learn or services. improve skills and functioning for daily living. Examples include therapy for a child who isn'c walking or talking ar Non-Prefered Provider the expected age. These services may include physical and A provider who doesn't have a concract with your health occupational therapy, speech-language pathology and insurer or plan to provide services ro you. You'll pay other services for people with disabilities in a variety of more to see a non-preferred provider. Check your policy inpatient and/ or outpatient settings. to see if you can go to all providers who have contracted with your hraltlr:irxurance or plan, or if your heakh Heakh Insurance insurance or plan has a "ciered" netwofk and you must A contract that requires your health insurer to pay some paF extra to see some providers. or all ofyour health care costs in exchange for a premi*m. Out-of-netwofk Co-insutance The percent (for example,4OYo) you pay of the allowed Home Heakh Care exlount for covered health care services to providers who Health care services a person receives ac home do not contract with your heakh insurance or plan. Out- of-network co-insurance usually coscs you more chan in- Hospice Services neiwork co-insurance. Services to provide comfort and support for persons in the last stages of a terminal illness and their families. Out-of-network Co-palim.ent A fixed amount (for example, $30) you pay for covered Hospitalization health care services from providers who do notcontract Care in a hospical that requires admission as an inpatient with your healch insurance or plan. Out-of-network co- and usually requires an ovemight shy. An overnight stay payments usually are more than in-c?erwork co*pa1':nents. for observation could be outpatient care. Out-of-Pocket Limit Hospitd Outpatient Care The most you pay during a Care in a hospital that usually doesn't require an policy period (usually a overnight stay. year) before your health irsura::ee or plar: begins to In-network Co-insurance pay IOOo/o of the allcwed arerolrnL This limit never The percent (for exampl e, 2O%) you pay of the allowed J;rnc pavs t-lcr plan plrr's ar:louna for covered health care services to pror.iders who includes your premiu:a, Oalo I0O% contract with your health irxurance or plan. In-nerwork baiance-billed charges or I sc* p:rge { to. rr dctrrileil c't;rrrrple ') co-insurance usually costs you less than out*af-network health care your h"dtl-r" c*-irxgrane*. insurance or plan doesn't cover. Some health insurance or plans don't count all of your co-peyraerts, deductibles, In-network Co-palment cc*inscrance payments, out-of-network payments or other expenses A fixed amount (for example, $I5) yo:u pay for covered toward this limir. health care services to prcviders who contract wirh your health ilsurance or plan. In-network co-paymenrs usually Physician Services are Iess than out*of*network co-pafmenfs. Health care services a licensed medical physician (M.D.- Medical Doctor or D.O. - Doctor of Osteopathic Medicine) provides or coordinares. Gloss*ry cf Health Coverage and Medical Terms Page 2 of 4 Ptan Provider A benefit your employer, union or other group sponsor A physician (M.D.- Medical Doctor or D.O. - Doctor provides to you to pay for your health care services. of Osteopathic Medicine), health care professional or health care facility licensed, certified or accredircd as Preagthorization required by state law. A decision by your health insurer or plan that a health care service, treatment plan, pres*:ipri*n drug or drerable Reconstnrctive Strrgery metiie*3 equipment is arredically neeessary. Sometimes Surgery and follow-up treatment needed to correct or called prior authorization, prior approval or improve a parc of the body because of birth defecrc, precertification. Your health insrrance or plan may accidents, injuries or medical conditions. require preauthorization for certain services before you receive them, except in an emergency. Preauchorization Rehabilitation Services isn't a promise your healch insurance or plan will cover Health care services that help a person keep, get back or the cost. improve skills and functioning for daily living that have been lost or impaired because a person was sick, hurt or Preferred Provider disabled. These services may include physical and A pr*vi&*r who has a contract with your health insurer or occupational therapy, speech-language pathology and plan to provide services to you ac a discount. Check your psychiatric rehabilitation services in a variety of inpatient policy to see ifyou can see all preferred providers or if and/ or outpatienr setrings. your h*alth insurance or plan has a "tiered" nefwork and you musc pay extra to see some providers. Your health Skilled Nursing Care insurance or plan may have preferred providers who are Services from licensed nurses in your own home or in a also "participating" providers. Participating providers nursing home. Skilled care services are from technicians also contract with your health insurer or plan, but the and therapists in your own home or in a nursing home. discount may not be as great, and you may have to pay more. Specialist A physician specialist focuses on a specific area of Premium medicine or a group of patients to diagnose, manage, The amount that must be paid for your health ir:srrance prevent or treat certain types of symptoms and or pla:1.
Load more

Recommended publications
  • DC Health Systems Plan 2017
    DISTRICT OF COLUMBIA HEALTH SYSTEMS PLAN 2017 NOTICE OF NON-DISCRIMINATION In accordance with the D.C. Human Rights Act of 1977, as amended, D.C. Code section 2.1401.01 et seq., the District of Columbia does not discriminate on the basis of race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, family responsibilities, matriculation, political affiliation, disability, source of income, or place of residence or business. Discrimination in violation of the Act will not be tolerated. Violators will be subject to disciplinary action. Published July, 2017 Dear Residents: Upon taking office in 2015, my Administration focused on improving health outcomes for all residents, recognizing that all government policies—from education and housing, to economic development and transportation—impact the health and wellness of our communities. Every Washingtonian, regardless of where they live, should have the ability to live a healthy and fulfilling life in our nation’s capital. This Health Systems Plan will serve as a guide for all stakeholders as they implement initiatives aimed at strengthening Washington DC’s health system to improve the overall health status of residents by ad- dressing social determinants of health and promoting health equity. Through this plan, we will ensure that public and private agencies throughout DC have the direction they need to make sound investments and implement initiatives that will improve the health and well-being of residents across all eight wards. I am proud of the work we have done thus far. In 2016, the number of newly diagnosed HIV cases in Washington, DC decreased by 52 percent to 347.
    [Show full text]
  • Chapter 54 Manual of Requirements for Family Child Care Registration
    CHAPTER 54 MANUAL OF REQUIREMENTS FOR FAMILY CHILD CARE REGISTRATION STATE OF NEW JERSEY DEPARTMENT OF CHILDREN AND FAMILIES EFFECTIVE - March 20, 2017 EXPIRES - February 21, 2024 DEPARTMENT OF CHILDREN AND FAMILIES OFFICE OF LICENSING PO BOX 717 TRENTON, NEW JERSEY 08625-0717 Toll - Free Telephone 1-877-667-9845 N.J.A.C. 3A:54 MANUAL OF REQUIREMENTS FOR FAMILY CHILD CARE REGISTRATION SUBCHAPTER 1. GENERAL PROVISIONS................................................................................ 1 3A:54-1.1 Legal authority ................................................................................................................ 1 3A:54-1.2 Definitions ....................................................................................................................... 2 3A:54-1.3 Approval requirements for sponsoring organizations ..................................................... 4 3A:54-1.4 Public access to records ................................................................................................... 6 SUBCHAPTER 2. ADMINISTRATION OF SPONSORING ORGANIZATIONS ................... 8 3A:54-2.1 Sponsoring organization eligibility ................................................................................. 8 3A:54-2.2 Administrative responsibility .......................................................................................... 8 3A:54-2.3 Reporting requirements ................................................................................................... 9 3A:54-2.4 Sponsoring organization records
    [Show full text]
  • Balance Billing Protection for Out-Of-Network Services
    Form 405-A (eff. 1/2021) BALANCE BILLING PROTECTION FOR OUT-OF-NETWORK SERVICES Starting January 1, 2021, Virginia state law may protect you from “balance billing” when you get: • EMERGENCY SERVICES from an out-of-network hospital, or an out-of-network doctor or other medical provider at a hospital; or • NON-EMERGENCY SURGICAL OR ANCILLARY SERVICES from an out-of-network lab or health care professional at an in-network hospital, ambulatory surgical center or other health care facility. What is balance billing? • An “IN-NETWORK” health care provider has signed a contract with your health insurance plan. Providers who haven’t signed a contract with your health plan are called “OUT-OF-NETWORK” providers. • In-network providers have agreed to accept the amounts paid by your health plan after you, the patient, has paid for all required cost sharing (copayments, coinsurance and deductibles for covered services). • But, if you get all or part of your care from out-of-network providers, you could be billed for the difference between what your plan pays to the provider and the amount the provider bills you. This is called “balance billing.” • The new Virginia law prevents certain balance billing, but it does not apply to all health plans. Applies May Apply Does Not Apply o Fully insured managed care plans, o Employer-based coverage o Health plans issued to an including those bought through o Health plans issued to an employer association outside Virginia HealthCare.gov outside Virginia o Health plans that do not use a o The state employee health plan o Short-term limited duration plans network of providers o Group health plans that opt-in o Limited benefit plans How can I find out if I am protected? Be sure to check your plan documents or contact your health plan to find out if you are protected by this law.
    [Show full text]
  • Tool 1. Scenarios Guide
    Tool 1. Scenarios Guide Tool 1. Scenarios Guide The following 18 scenarios were developed specifically for the privacy and security project to provide a standardized context for discussing organization-level business practices across all states and territories. The scenarios represent a wide range of purposes for the exchange of health information (eg, treatment, public health, biosurveillance, payment, research, marketing) across a broad array of organizations involved in health information exchange and actors within those organizations. The product of the “guided or focused” discussions will be a database of organization-level business practices that will form the basis for the assessment of variation upon which all other work will be based. Each scenario describes a health information exchange (HIE) within a given context to ensure that we cover most of the areas in which we expect to find barriers. Clearly, these scenarios do not cover the universe of exchanges. However, the purposes and conditions represented should be more than adequate to get the discussions of privacy and security policy moving forward. Exhibit 1 shows a mapping of stakeholder organizations identified in the HIE scenarios. A shaded box containing an “X” with some additional text indicates stakeholders that are explicitly identified in the scenario. A yellow box with no text indicates a stakeholder group that could conceivably weigh in on a scenario. For example, Scenario 1: Patient Care Scenario A, involves an exchange between the emergency room in Hospital A and an out-of- state hospital, Hospital B. Both the requesting and releasing organizations are hospitals, regardless of the actors that may be representing those organizations in the work group meetings, which may include physicians, nurses, health information management professionals, and others.
    [Show full text]
  • Kansas Department of Health and Environment
    KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT KANSAS LAWS AND REGULATIONS FOR LICENSING DAY CARE HOMES AND GROUP DAY CARE HOMES FOR CHILDREN JANUARY 2020 Division of Public Health Bureau of Family Health Child Care Licensing Program 1000 SW Jackson, Suite 200, Topeka, KS 66612-1274 Phone: (785) 296-1270 Fax: (785) 559-4244 Website: http://www.kdheks.gov/bcclr/index.html E-mail: [email protected] TABLE OF CONTENTS I. Kansas Child Care Licensing Laws, Revised July 2018 Page K.S.A. 65-501 License or temporary permit required; exemptions ...........................1 K.S.A. 65-503 Definitions .........................................................................................1 K.S.A. 65-504 Licenses; contents; limitations; posting; inspections; temporary permits; access to premises; temporary licenses; denial or revocation of license; procedure ........................................................2 K.S.A. 65-505 License fees; maternity centers and child care licensing fee fund .....4 K.S.A. 65-506 Notice of issuance, limitation, modification, suspension or revocation of license; notice to parents or guardians of enrollees of limitation, modification, suspension, revocation or denial; unlicensed placements prohibited ......................................................5 K.S.A. 65-507 Records of maternity centers and child care facilities; confidentiality ....................................................................................6 K.S.A. 65-508 Equipment, supplies, accommodations; competent supervision and care of children; safe
    [Show full text]
  • Pdf Examination Performances of U.S
    U.S. Health Care Workforce By John J. Norcini, John R. Boulet, W. Dale Dauphinee, Amy Opalek, Ian D. Krantz, and Suzanne T. Anderson doi: 10.1377/hlthaff.2009.0222 HEALTH AFFAIRS 29, NO. 8 (2010): 1461–1468 ©2010 Project HOPE— Evaluating The Quality Of Care The People-to-People Health Foundation, Inc. Provided By Graduates Of International Medical Schools John J. Norcini (jnorcini@ ABSTRACT One-quarter of practicing physicians in the United States are FAIMER.org) is president and graduates of international medical schools. The quality of care provided chief executive officer of the Foundation for Advancement by doctors educated abroad has been the subject of ongoing concern. Our of International Medical Education and Research analysis of 244,153 hospitalizations in Pennsylvania found that patients (FAIMER), in Philadelphia, of doctors who graduated from international medical schools and were Pennsylvania. not U.S. citizens at the time they entered medical school had significantly John R. Boulet is associate lower mortality rates than patients cared for by doctors who graduated vice president for research and data resources at from U.S. medical schools or who were U.S. citizens and received their FAIMER. degrees abroad. The patient population consisted of those with congestive heart failure or acute myocardial infarction. We found no W. Dale Dauphinee is a senior scholar at FAIMER. significant mortality difference when comparing all international medical graduates with all U.S. medical school graduates. Amy Opalek is a data resource specialist at FAIMER. Ian D. Krantz is an associate professor of pediatrics at the Children’sHospitalof raduates of international medical We hope that the results will serve as a spring- Philadelphia and the Division schools make up approximately board for changes in medical education practices of Human Genetics and Molecular Biology at the one-quarter of U.S.
    [Show full text]
  • Prescription Drug Benefit Manual Chapter 7 – Medication Therapy Management and Quality Improvement Program
    Prescription Drug Benefit Manual Chapter 7 – Medication Therapy Management and Quality Improvement Program Table of Contents (Rev. 11, 02-19-10) Transmittals for Chapter 7 10 – Medication Therapy Management and Quality Improvement Program 10.1 Introduction 10.2 Definition of Terms 20 – Quality Assurance Requirements 20.1 – General Rule 20.2 – Compliance With State Standards 20.3 – Concurrent Drug Utilization Review (DUR) 20.4 – Retrospective Drug Utilization Review (RDUR) 20.5 – Medication Error Identification and Reduction (MEIR) 20.6 – Medwatch Reporting 20.7 – CMS Performance Measures 20.8 – Information for Quality Improvement Organizations (QIOs) 30 – Medication Therapy Management Program (MTMP) 30.1 – General Rule 30.2 – Targeted Beneficiaries 30.3 – MTM Services 30.4 – Use of Experts 30.5 – Considerations in MTMP Fees 30.6 – MTMP Application 30.7 – MTMP Approval Considerations 30.8 – Mid–Year MTMP Changes 30.9 – MTMP Reporting 30.10 - Claims Processing for MTM Services 40 – Consumer Satisfaction Surveys 40.1 – General Rule 40.2 – Part D Sponsor Follow-up Responsibilities 50 – Electronic Prescription Program (E-prescribing) 50.1 – General Rule 50.2 – State Law Preemption 50.3 – Standards for E-Prescribing 50.4 – Exemptions 50.5 – Promotion of Electronic Prescribing by MA-PD Plans 60 – Drug Utilization Management Program 60.1 – General Rule 60.2 – Over-the-Counter Drugs as Part of Utilization Management Programs 60.3 – Exception for Private Fee-for-Service MA Plans 60.4 – Drug Utilization Management Disclosure Requirements 60.5 – Web site Posting Requirements 60.6 – Revision of Utilization Management Criteria Requirements 70 - Part D Complaints Processing 70.1 – General Rule 70.2 – Timeframes for Complaints Processing Appendix A – Chapter 7 Related Web Sites 10 – Medication Therapy Management and Quality Improvement Program (Rev.
    [Show full text]
  • Certification of Health Care Provider Employee Health Condition Family and Medical Leave Act of 1993 (“FMLA”)
    Human Resources Division 250 E 200 S Suite 125, Salt Lake City, Utah 84111 Fax: (801) 585-7375 Certification of Health Care Provider Employee Health Condition Family and Medical Leave Act of 1993 (“FMLA”) SECTION I: For Completion by the EMPLOYEE INSTRUCTIONS to the EMPLOYEE: Please complete Section I before giving this form to your medical provider. The FMLA permits the University to require that you submit a timely, complete, and sufficient medical certification to support a request for FMLA leave due to your own serious health condition. This Certification is required to obtain or retain the benefit of FMLA protections. 29 U.S.C. §§ 2613, 2614(c)(3). Failure to provide a complete and sufficient medical certification may result in a denial of your FMLA request. 20 C.F.R. § 825.313. Your completed form must be returned to the University’s Absence Management Team within 15 calendar days. 29 C.F.R. § 825.305(b). Employee Name: University Employee Identification Number: I hereby authorize a representative of the University of Utah Division of Human Resources to contact my Health Care Provider for purposes of clarification and/or authentication of this Certificate of Health Care Provider. Signature of Employee Date SECTION II: For Completion by the HEALTH CARE PROVIDER INSTRUCTIONS to the HEALTH CARE PROVIDER: Your patient has requested leave under the FMLA. Please answer, fully and completely, all applicable parts. Several questions seek a response as to the frequency or duration of a condition, treatment, etc. Your answer should be your best estimate based upon your medical knowledge, experience, and examination of the patient.
    [Show full text]
  • Rules and Regulations for the Utilization Review of Health Care Services (R23
    RULES AND REGULATIONS FOR THE UTILIZATION REVIEW OF HEALTH CARE SERVICES (R23-17.12-UR) STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS Department of Health August 1993 (E) As amended: August 1993 December 1993 (E) February 1994 May 1994 (E) July 1994 March 1997 May 1997 April 1998 (E) July 1998 January 2000 March 2001 November 2001 January 2002 (re-filing in accordance with the provisions of section 42-35- 4.1 of the Rhode Island General Laws, as amended) October 2002 April 2004 February 2007 INTRODUCTION These Rules and Regulations for the Utilization Review of Health Care Services (R23- 17.12-UR) are promulgated pursuant to the authority conferred under Chapters 23-17.12 and 42-35 of the General Laws of Rhode Island, as amended, and are established for the purpose of defining minimum standards for the utilization review of health care services, and the delivery of health care in a cost effective manner. In accordance with the provisions of section 42-35-3 (c) of the General Laws of Rhode Island, as amended, in the development of the regulations, consideration was given to: (1) alternative approaches to the regulations; and (2) duplication or overlap with other state regulations. Based on the available information, no known alternative approach, duplication or overlap was identified. These amended regulations shall supersede all previous Rules and Regulations for the Utilization Review of Health Care Services (R23-17.12-UR) promulgated by the Department of Health and filed with the Secretary of State. i TABLE OF CONTENTS Page 1.0 Definitions
    [Show full text]
  • Legislative Bill 337
    LB337 LB337 2021 2021 LEGISLATURE OF NEBRASKA ONE HUNDRED SEVENTH LEGISLATURE FIRST SESSION LEGISLATIVE BILL 337 FINAL READING Introduced by Kolterman, 24. Read first time January 13, 2021 Committee: Banking, Commerce and Insurance 1 A BILL FOR AN ACT relating to prescription drug coverage; to adopt the 2 Step-Therapy Reform Act; and to provide a duty for the Revisor of 3 Statutes. 4 Be it enacted by the people of the State of Nebraska, -1- LB337 LB337 2021 2021 1 Section 1. Sections 1 to 7 of this act shall be known and may be 2 cited as the Step-Therapy Reform Act. 3 Sec. 2. For purposes of the Step-Therapy Reform Act: 4 (1) Clinical practice guidelines means a systematically developed 5 statement to assist decisionmaking by health care providers and decisions 6 by covered persons about appropriate health care for specific clinical 7 circumstances and conditions; 8 (2) Clinical review criteria means the written screening procedures, 9 decision abstracts, clinical protocols, and clinical practice guidelines 10 used by a health carrier or utilization review organization to determine 11 the medical necessity and appropriateness of health care services; 12 (3) Health carrier means an entity subject to the insurance laws and 13 regulations of this state, or subject to the jurisdiction of the Director 14 of Insurance, that contracts or offers to contract to provide, deliver, 15 arrange for, pay for, or reimburse any of the costs of health care 16 services, including a sickness and accident insurance company, a health 17 maintenance organization, a nonprofit hospital and health service 18 corporation, or any other entity providing a plan of health insurance, 19 health benefits, or health care services.
    [Show full text]
  • Engaging Health Care Users: a Framework for Healthy Individuals and Communities
    Engaging Health Care Users: A Framework for Healthy Individuals and Communities A Report of the AHA Committe on Research: Benjamin K. Chu, MD, Cheryl Hoying, PhD, RN co-chair Mary J. Kitchell John G. O’Brien, co-chair Stephen Love Rhonda Anderson, DNSc, FACHE Thomas D. O’Connor Thomas L. Bell T.R. Reid Art Blank Michael G. Rock, MD Mary Blunt Jeff Selberg Pamela S. Brier Anthony L. Spezia Lawrence P. Casalino, MD, PhD David P. Tilton Michael Chernew, PhD Richard J. Umbdenstock Douglas A. Conrad, PhD Lorrie Warner Elaine Couture, MBA, RN Maryjane Wurth Brenita Crawford, DHA Steven I. Goldstein American Hospital Association 2012 Committee on Research Benjamin K. Chu, MD Michael Chernew, PhD Thomas D. O’Connor Committee Co-Chair Professor President Regional President Department of Health Care Policy United Hospital Southern California, Kaiser Foundation Harvard Medical School Hospitals T.R. Reid Douglas A. Conrad, PhD Author John G. O’Brien Professor Committee Co-Chair Department of Health Services Michael G. Rock, MD President and Chief Executive Officer University of Washington Chief Medical Officer UMass Memorial Health Care, Inc. Mayo Clinic Hospitals/Mayo Foundation Elaine Couture, BSN, MBA, RN Rhonda Anderson, DNSc, Chief Executive Officer Jeff Selberg FAAN Providence Sacred Heart Executive Vice President and Chief Executive Officer Medical Center Chief Operating Officer Cardon Children’s Medical Center Institute for Healthcare Improvement Brenita Crawford, DHA Thomas L. Bell Retired Healthcare Executive and Educator Anthony L. Spezia President and Chief Executive Officer President and Chief Executive Officer Kansas Hospital Association Steven I. Goldstein Covenant Health President and Chief Executive Officer Art Blank University of Rochester - Strong Memo- David P.
    [Show full text]
  • Glossary of Commonly Used Health Care Terms and Acronyms
    GLOSSARY OF COMMONLY USED HEALTH CARE TERMS AND ACRONYMS Vermont Health Care Resources 1 Health Care Terms A and dividends, as well as conducted other statistical studies. academic medical center A group of acute care Medical treatment rendered to related institutions including a teaching individuals whose illnesses or health hospital or hospitals, a medical school and problems are of short-term or episodic its affiliated faculty practice plan, and other nature. Acute care facilities are those health professional schools. hospitals that mainly serve persons with short-term health problems. access An individual’s ability to obtain appropriate health care services. Barriers to acute disease A disease characterized by a access can be financial (insufficient single episode of a relatively short duration monetary resources), geographic (distance to from which the patient returns to his/her providers), organizational (lack of available normal or pervious state of level of activity. providers) and sociological (e.g., While acute diseases are frequently discrimination, language barriers). Efforts to distinguished from chronic diseases, there is improve access often focus on no standard definition or distinction. It is providing/improving health coverage. worth noting that an acute episode of a chronic disease (for example, an episode of accident insurance A policy that provides diabetic coma in a patient with diabetes) is benefits for injury or sickness directly often treated as an acute disease. resulting from an accident. adjusted average per capita cost accreditation A process whereby a program (AAPCC) The basis for HMO or CMP of study or an institution is recognized by an (Competitive Medical Plan) reimbursement external body as meeting certain under Medicare-risk contracts.
    [Show full text]