Healthcare-Related Terms, Abbreviations and Acronyms
403 Report
Aa
A&F
AA
AAHC/URAC
AAHP
AAHSA
AAMC
AAP
AAPCC
AARC
AARP
ABMS
ABN
ACA
ACC
ACE
ACGME
ACHE
ACIP
ACLF
ACO
ACOG
ACPE
ACR
ACS
ADA
ADC
ADE
ADHC
ADLs
ADN
ADS
ADT
AFDC
AG
AHA
AHAPAC
Hospital statement of costs, revenues and statistics - a detailed cost report that each
Massachusetts-based hospital is required to submit to the DHCFP each year
Administration & Finance
Anesthesiologist assistant
American Accreditation Healthcare Commission (formerly Utilization Review
Accreditation Commission)
American Association of Health Plans
American Association of Homes and Services for the Aging
Association of American Medical Colleges
American Academy of Pediatrics
Average adjusted per capita cost
American Association of Respiratory Care
American Association of Retired Persons
American Board of Medical Specialties
Advance beneficiary notice
Federal “Patient Protection and Affordable Care Act”
American College of Cardiology
Acute care episode
Accreditation Council for Graduate Medical Education
American College of Healthcare Executives
Advisory Committee on Immunization Practices
Assisted care living facility
Accountable care organization – combination of providers accountable for the quality
and cost of healthcare for a population of Medicare beneficiaries
American College of Obstetricians and Gynecologists
American College of Physician Executives
Adjusted community rate
American College of Surgeons
Americans with Disabilities Act
American Diabetes Association
Average daily census
Adverse drug event
Adult day health care
Activities of daily living
Associate degree in nursing
Alternative delivery system
Admission, discharge and transfer
Aid to Families with Dependent Children
Attorney General
American Hospital Association
American Heart Association
American Hospital Association Political Action Committee
1
AHCA
AHCPR
AHEA
AHIMA
AHIP
AHLA
AHRA
AHRQ
AHRMM
AIDS
AIM
AKS
ALC
ALOS
ALP
ALS
AMA
AMCs
AMI
AMS
ANA
AOA
AONE
APC
APCD
APG
APHA
APM
APN
APR DRG
AQC
ARC
ARRA
ASAE
ASC
ASDVS
ASHE
ASHES
ASHFSA
ASHHRA
ASHP
ASHRM
ASO
ASPPB
ASTC
American Health Care Association
Agency for Health Care Policy and Research now know as AHRQ
Association of Healthcare Executive Assistants
American Health Information Management Association
America’s Health Insurance Plan
American Health Lawyers Association
American Healthcare Radiology Administrators
Agency for Healthcare Research and Quality, DHHS - formerly “Agency for Health
Care Policy and Research”
Association for Healthcare Resource & Materials Management (AHA)
Acquired immunodeficiency syndrome
Associated Industries of Massachusetts
Anti-kickback statute
Alternate level of care
Average length of stay
Assisted living program
Advanced life support
American Medical Association
Academic medical centers
Acute myocardial infarction
Applied Management System
American Nurses Association
Administration on Aging, DHHS
American Osteopathic Association
American Organization of Nurse Executives
Ambulatory procedure codes
Ambulatory payment classification
All-payer claims database
Ambulatory patient group
American Public Health Association
Alternative payment method
Advanced practice nurse
All patient refined diagnosis-related group
Alternative Quality Contract (Blue Cross Blue Shield global payment model with
performance incentives)
American Red Cross
American Recovery and Reinvestment Act of 2009 (commonly referred to as the federal
stimulus act or recovery act)
American Society of Association Executives
Ambulatory surgical center
American Society for Directors of Volunteer Services
American Society for Healthcare Engineering
American Society for Healthcare Environmental Services
American Society for Healthcare Food Service Administrators
American Society for Healthcare Human Resources Administration
American Society of Health-System Pharmacists
American Society for Healthcare Risk Management
Administrative Services Organization
Association of State and Provincial Psychology Boards
Ambulatory surgical treatment center
2
ASTHO
AWP
Association of State and Territorial Health Officials - a national nonprofit organization
representing U.S. public health agencies, and the 120,000 public health professionals the
agencies employ
Area Wage Index – an adjustment in the Medicare rates to accommodate differences in
hospital wage levels by geographic area
Average wholesale price
Bb
BBA
BBRA
BCBS
BCBSMA
BIPA
BHE
BHO
BIPA
BME
BMV
BORM
BSN
Balanced Budget Act of 1997
Balanced Budget Refinement Act of 1999
Blue Cross Blue Shield
BlueCross BlueShield of Massachusetts
Benefits Improvement and Protection Act
Board of Higher Education
Behavioral health organization
Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000
Board of Medical Examiners
Bedside Medication Verification
Board of Registration in Medicine (state agency)
Bachelor of science in nursing
AWI
Cc
CAH
CAHPS
CAI
CAO
CAP
Capitation
CAT
CAUTI
CBO
CBSA
CC
CCHIP
CCI
CCIP
CCR
CCTP
Critical Access Hospital - A small, generally geographically remote facility that
provides outpatient and inpatient hospital services to people in rural areas. The
designation was established by law, for special payments under the Medicare program.
To be designated as a CAH, a hospital must be located in a rural area, provide 24-hour
emergency services; have an average length-of-stay for its patients of 96 hours or less;
be located more than 35 miles (or more than 15 miles in areas with mountainous terrain)
from the nearest hospital or be designated by its State as a "necessary provider".
Hospitals may have no more than 25 beds.
Consumer Assessment of Healthcare Providers and Systems
Cooperative Accreditation Initiative – this initiative permits the Joint Commission to
rely on other oversight or accrediting organizations where it would otherwise conduct
duplicative surveys of organizations seeking dual accreditation
Chief administrative officer
Capitation
College of American Pathologists
A fixed payment remitted at regular intervals to a medical provider by a managed care
organization for an enrolled patient.
Computerized axial tomography
Catheter associated urinary tract infection
Congressional Budget Office
Core-based statistical area
Complications and comorbidities
Commonwealth Care Health Insurance Program
Correct Coding Initiative
Chronic Care Improvement Program (Medicare)
Cost-to-charge ratio
Community-based Care Transitions Program – federal program created under ACA
Section 3026 to improve transitions of patients from hospital to other settings
3
CCU
Cardiac care unit
Coronary care unit
CDAC
Clinical Data Abstraction Center
CDC
Centers for Disease Control and Prevention, DHHS
CE
Continuing education
CEHRT
Certified Electronic Health Record Technology
CEO
Chief executive officer
CfCs
Conditions for coverage
CFO
Chief financial officer
CFR
Code of Federal Regulations
CGB
Cost growth benchmark
CHA
Catholic Health Association
Center for Health Affairs
Cambridge Health Alliance
CHAMPUS
Civilian health and medical program of the uniformed services
CHAMPVA
Civilian health and medical program of the Veteran’s Administration
CHAP
Community health accreditation program
CHART Grants Community Hospital Acceleration, Revitalization, and Transformation grants funded
through a one-time assessment under Chapter 224 to benefit distressed hospitals in
Massachusetts
CHF
Congestive heart failure
CHG
Center for Healthcare Governance (AHA)
CHIA
Center for Health Information and Analysis – MA state agency which replaced DHCFP
CHIN
Community health information network
CHIP
Children's health insurance program
CHNA
Community health needs assessment
CIAC
Clinical Issues Advisory Council, MHA
CLABSI
Central line-associated blood stream infection
CLIA
Clinical Laboratory Improvement Act
Clinical laboratory improvement amendments
CLT
Clinical laboratory technologist
CME
Continuing medical education
CMED
Coordinated Medical Emergency Direction
CMEMSC
Central Mass. Emergency Medical Services Corp.
CMG
Case-mix group
CMHC
Community mental health center
CMI
Case mix index
CMP
Civil monetary penalty
CMS
Centers for Medicare & Medicaid Services, DHHS (formerly HCFA) - US federal
agency which administers Medicare, Medicaid, and the State Children's Health
Insurance Program (SCHIP)
CNA
Certified nurse aide
CNM
Certified nurse midwife
CMO
Chief medical officer
CNO
Chief nursing officer
CNP
Certified nurse practitioner
CNS
Clinical nurse specialist
COB
Coordination of benefits
COBRA
Consolidated Omnibus Budget Reconciliation Act of 1985
COBTH
Conference of Boston Teaching Hospitals
CON
Certificate of need
4
Connector
COO
CORF
CPE
CPHA
CPI
CPOE
CPQ
CPR
CPT
CQI
CQM
CRNA
CSR
CT
CUSP
CVO
CY
Dd
DB Plan
DC
DCF
DCI
DDS
DHCEP
DHCFP
DHF
DHHS
DHS
DMA
DMAT
DMD
DME
DMH
DMO
DMR
DMS
DNR
DO
DOI
DOJ
DoN
DOS
DPH
DPM
Commonwealth Health Insurance Connector Authority (MA state)
Chief operating officer
Comprehensive outpatient rehabilitative facility
Certified public expenditures
Commission on Professional and Hospital Activities
Consumer price index
Computerized physician/provider order entry
Certificate of Professional Qualification in Psychology
Cardiopulmonary resuscitation
Current procedural terminology
Continuous quality improvement
Clinical quality measures
Certified registered nurse anesthetist
Continuous survey readiness
Computerized tomography
Comprehensive Unit-based Safety Program
Credentialing Verification Organizations
Calendar year
Defined Benefit (pension) Plan
Doctor of chiropractic
Department of Children and Families (state) – formerly Department of Social Services
Duplicate coverage inquiry
Doctor of dental surgery
Department of Developmental Services (state) – formerly Department of Mental
Retardation
Division of Health Care Emergency Preparedness, Health Resources and Services
Administration, DHHS
Division of Health Care Finance and Policy (MA state – see CHIA)
Distressed hospital fund (MA state)
Department of Health and Human Services (federal agency)
Department of Homeland Security
Designated health service
Division of Medical Assistance (MA state)
Disaster Management Assistance Teams
Doctor of medical dentistry
Durable medical equipment
Department of Mental Health (state)
Disease management organization
Department of Mental Retardation (state) – now known as DDS
Diagnostic medical sonographers
Do not resuscitate
Doctor of osteopathy
Division of Insurance (MA state)
U.S. Department of Justice
Determination of need
Date of service
Department of Public Health (MA state)
Doctor of podiatric medicine
5
DPR
DPT
DRA
DRG
DSH
DUR
DVS
DVT
Ee
EACH
EAP
EAPG
ECF
ED
EDI
EDW
EEG
EEOC
EGR
EH Audits
EHR
EIP
EKG
EMAC
eMAR
EMR
EMS
EMT
EMTALA
EOB
EOC
EOHHS
EP audits
EPA
EPO
EPPP
EPSDT
ER
ERISA
ESAR-VHP
Drug price review
Doctor of Physical Therapy
Deficit Reduction Act
Diagnosis-related group
Disproportionate share hospitals - Hospitals that serve a significantly disproportionate
number of low-income patients, and are eligible to receive special adjustment payments
from HHS. States receive an annual DSH allotment to cover the costs of DSH hospitals
that provide care to low-income patients that are not paid by other payers, such as
Medicare, Medicaid, the Children’s Health Insurance Program (CHIP) or other health
insurance. This annual allotment is calculated by law and includes requirements to
ensure that the DSH payments to individual DSH hospitals are not higher than these
actual uncompensated costs.
Drug utilization review
Director of volunteer services
Deep vein thrombosis
Essential access community hospital
Employer Action Coalition for Health Care
Employee assistance plan/program
Enhanced ambulatory patient group
Extended care facility
Emergency department
Electronic data interchange
Electronic data warehouse
Electroencephalogram
Equal Employment Opportunity Commission
Elderly Governmental Retiree (term used by GIC)
Eligible hospital audits
Electronic health record
Early intervention program
Electrocardiogram
Emergency Management Assistance Compact
Electronic medication administration record
Electronic medical record
Emergency medical services
Emergency medical technician
Emergency Medical Treatment and Active Labor Act
Explanation of benefits
Emergency Operations Center
Executive Office of Health & Human Services (MA state)
Eligible participants audit
Environmental Protection Agency
Exclusive provider organization
Examination for Professional Practice in Psychology
Early periodic screening diagnosis and treatment program
Emergency room
Employee Retirement Income Security Act
Emergency System for Advanced Registration of Volunteer Health Professionals
6
Ff
FACHE
FACMPE
FAH
FDA
FDO
FEBHP
FEMA
FFP
FFS
FFY
FHA
FI
FICA
FMAP
FOIA
FPL
FQHC
FSA
FSMB
FTC
FTE
FY
Gg
GA
GAO
Fellow in the American College of Healthcare Executives
Fellow in the American College of Medical Practice Executives
Federation of American Hospitals
U.S. Food and Drug Administration, DHHS
Formula-driven overpayment
Federal Employee Benefits Health Plan
Federal Emergency Management Agency
Federal financial participation
Fee-for-service
Federal fiscal year
Farmers Home Administration
Federal Housing Administration
Fiscal intermediary
Federal Insurance Contribution Act
Federal medical assistance percentage - used in determining the amount of federal
matching funds for state expenditures for assistance payments for certain social services,
and state medical and medical insurance expenditures (Medicaid)
Freedom of Information Act
Federal poverty level
Federally qualified health center
Flexible Spending Account (Sec. 125 tax savings account)
Federation of State Medical Boards
Federal Trade Commission
Full-time equivalent
Fiscal year
GME
GPO
General assistance
U.S. Government Accountability Office - Investigative arm of Congress charged with
examining matters relating to the receipt and payment of public funds.
Government advocacy staff
Group Insurance Commission – part of the Massachusetts Executive Office of
Administration & Finance, the GIC provides health insurance and other benefits to state,
housing and certain other authorities' employees, retirees, and their
survivors/dependents. The GIC also provides health-only benefits to participating
municipalities' employees, retirees, and their survivors/ dependents.
Graduate medical education
Group purchasing organization
Hh
HAC
HAIs
HB
HBIPS
HCA
Hospital-acquired condition
Healthcare-associated infections
House bill
Hospital-based inpatient psychiatric services
Home Care Alliance of Massachusetts
GAS
GIC
7
HCAHPS
HCAP
HCBS
HCCGB
HCE
HCEA
HCFA
HCMA
HCPCS
HCQCC
HCQIA
HEDIS
HEFA
HEICS
HEN
HFMA
HHA
HHAN
HHC
HHS
HIAA
HIC
HICS
HIDI
HIE
HIM
HIMSS
HIPAA
HIPC
HIT
HITECH
HIV
HMO
HOP-HAC
HOPD
HPC
HPN
HPP
HPSA
HQA
HR
HRA
HRET
HRSA
Hospital Consumer Assessment of Health Providers and Systems - a government survey
for measuring patient satisfaction at hospitals across the country. The categories focus
on communication with doctors and nurses, responsiveness of hospital staff, pain
management, cleanliness and quietness of the hospital environment, and instructions
about medications and discharge.
Hospital care assurance program
Home- and community-based services
Health care cost growth benchmark
Health care experience
Health Care Executive Assistants (AHA)
Health Care Financing Administration (now CMS)
Health Care for All
Health Care Management Association
Healthcare common procedure coding system
Health Care Quality and Cost Council
Health Care Quality Improvement Act
Health employer data information set
Health and Educational Facilities Authority (state) – merged into MassDevelopment
Hospital Emergency Incident Command System
Hospital Engagement Network
Healthcare Financial Management Association
Home health agency
Heath and Homeland Alert Network
Home health care
U.S. Department of Health and Human Services (federal)
Health Insurance Association of America
Health insuring corporation
Hospital incident command system
Hospital Industry Data Institute
Health information exchange
Health information management
Healthcare Information & Management Systems Society
Health Insurance Portability and Accountability Act of 1996
Health insurance purchasing cooperative
Health information technology
Health Information Technology for Economic and Clinical Health Act of 2009
Human immunodeficiency virus
Health maintenance organization
Hospital outpatient healthcare-associated condition
Hospital outpatient department
Health Policy Commission (MA state agency setting health care cost growth goals)
Health Planning Council
Health provider network
Health partnership program
Health professional shortage area
Hospital Quality Alliance
House resolution
Human resources
Health reimbursement account/arrangements
Health Resources & Educational Trust (AHA)
Health Resources and Services Administration, DHHS
8
HSA
HSN
HSDA
HVSO
Ii
IBNR
ICD-9-CM
ICD-10-CM
ICD-10-PCS
ICF
ICN
ICU
IDN
IDS
IEMAC
IfD
IGT
IHI
IMD
IME
INHL
INQRI
IO
IOM
IOO
IPA
IPAB
IPF
IPPS
IQI
IRB
IRBO
IRF
IRS
ISCU
ISMP
IT
Health savings account
Health service agency
Health Safety Net
Health Services and Development Agency
Hospital volunteer services organization
Incurred but not reported
International classification of diseases, 9th revision
International classification of diseases, 10th revision
International classification of disease, 10th revision, procedure coding system
Intermediate care facility
Internal control number
Intensive care unit
Integrated delivery network
Integrated delivery system
International Emergency Management Assistance Compact
Institute for Diversity in Health Management (AHA)
Intergovernmental transfer
Institute for Healthcare Improvement
Institute for Mental Disease
Indirect medical education
Institute for Nursing Healthcare Leadership
Interdisciplinary Nursing Quality Research Initiative
Intermediary organization
Institute of Medicine of the National Academy of Sciences
Implementation and Optimization Organizations offer federally subsidized consulting
services targeted at small primary care physician practices so that they can acquire and
implement electronic health records (EHRs) and meet meaningful use standards
Independent practice association - Under an IPA arrangement, licensed professional
persons provide services (medicine, osteopathy, dentistry) through the entity in
accordance with a mutually accepted compensation arrangement, while retaining their
private practices.
Independent Payment Advisory Board
Inpatient psychiatric facility
Inpatient Prospective Payment System - Facilities contract with Medicare to furnish
inpatient care and agree to accept predetermined IPPS rates as payment in full. The
inpatient hospital benefit covers beneficiaries for 90 days of care per episode of illness
with an additional 60-day lifetime reserve. Illness episodes begin when beneficiaries are
admitted and end after they have been out of the hospital or Skilled Nursing Facility
(SNF) for 60 consecutive days.
Inpatient quality indicator
Ratio of FTE residents to inpatient beds. An IRB of 0.25 or greater is treated as a
teaching hospital by DHCFP and MEDPAC
Integrated Risk Bearing Organization (term used by GIC)
Inpatient rehabilitation facility
Internal Revenue Service
Influenza Specialty Care Unit
Institute for Safe Medication Practices
Information technology
9
Jj
JAMA
JAR
JC
JCAHO
JCR
Journal of the American Medical Association
Joint Annual Report of Hospitals
Joint Commission
Joint Commission on Accreditation of Healthcare Organizations
Joint Commission Resources
Kk
Ll
LCSW
LICSW
LISW
LIP
LOS
LPN
LSW
LTAC
LTC
LTCF
LTACH/LTCH
LTD
LUPA
LWDII
Licensed clinical social worker
Licensed independent clinical social worker
Licensed independent social worker
Low-income patient
Length of stay
Licensed practical nurse
Licensed social worker
Long-term acute care
Long-term care
Long-term care facility
Long-term (acute) care hospital
Long-term disability
Low utilization payment adjustment
Lost work day injury and illness
Mm
M-LiNk
MA
MABHS
MAC
MACEP
MACRMI
MAHP
MARN
MCC
MCCH
MCO
MCPSS
MD
MDCs
MDH
MDS
Medicaid
Medicare
MedPAC
MedPAR
MeHI
MEDPAC
Mortality: Learning-in-Network (M-LiNk)
Medical assistance
Massachusetts Association of Behavioral Health Systems
Medicare administrative contractor
Massachusetts College of Emergency Physicians
Massachusetts Alliance for Communication and Resolution Following Medical Injury
Massachusetts Association of Health Plans
Massachusetts Association of Registered Nurses
Managed care contractor
Massachusetts Council of Community Hospitals
Managed care organization
Medicare contractor provider satisfaction survey
Medical doctor
Major diagnosis categories
Medicare-dependent hospital
Minimum data set
A program, funded by the federal and state governments, which pays for medical care
for those who can't afford it.
A federal program that pays for certain health care expenses for people aged 65 or older.
Medicare Payment Advisory Commission
Medicare provider analysis and review
Massachusetts e-Health Institute (a division of MTC)
Medicare Payment Advisory Commission
10
MFN
MHA
MHDC
MHIMA
MHPAEA
MHQP
MIC
MIP
MIPPA
MITSS
MLR
MMA
MMIS
MMRS
MMS
MMSEA
MMWR
MNA
MNPA
MOLST
MONE
MOU
MPFS
MPH
MPS
MRA
MRC
MRI
MRSA
MSA
MSAR
MSDRG
MSEHPA
MSHP
MSN
MSO
MTC
MUA
MUP
Most favored nation
Massachusetts Hospital Association
Massachusetts Health Data Consortium
Massachusetts Health Information Management Association
Mental Health Parity and Addiction Equity Act of 2008
Massachusetts Health Quality Partnership
Medicaid integrity contractor
Medicaid Integrity Program
Medicare Improvements for Patients and Providers Act of 2008
Medically Induced Trauma Support Services
Medical Loss Ratio – to be defined by DHCFP regulations pursuant to MA Senate Bill
2585 §50
Medicare Modernization Act - Medicare Prescription Drug, Improvement &
Modernization Act of 2003
Medical management information system
Metropolitan Medical Response System
Mass Medical Society
Medicare, Medicaid, and SCHIP Extension Act of 2007
Morbidity and mortality weekly report
Massachusetts Nurses Association
Model Nurse Practice Act
Medical order for life sustaining treatment
Massachusetts Organization of Nurse Executives (former name of ONL – Organization
of Nurse Leaders of Massachusetts and Rhode Island)
Memorandum of understanding
Medicare physician fee schedule
Master’s in public health
Massachusetts Psychiatric Society
Magnetic resonance angiography
Medical Reserve Corps
Magnetic resonance imaging
Methicillin-resistant Staphylococcus aureus
Medical savings account
Metropolitan statistical area
Massachusetts System for Advance Registration
Medicare severity diagnosis-related group
Model State Emergency Health Powers Act
Master of Science in Health Policy Research
Massachusetts Society of HealthSystems Pharmacists (also related Maine, Maryland,
Minnesota, Mississippi and Missouri orgs)
Master of science in nursing
Medicare summary notice
Management service organization
Massachusetts Technology Collaborative - a public economic development agency that
promotes technology-related enterprise in Massachusetts
Medically underserved area
Medically underserved population
11
Nn
NAHDO
NAIC
NAPH
NAPHS
NBHPP
NBME
NBOME
NBRC
NCCMERP
NCD
NCHS
NCHSR
NCLEX-RN
NCQA
NCSBN
NDC
NDMS
NEHRA
NEMA
NEMC
NEQCA
NFP
NFPA
NHSC
NIC
NICU
NIH
NIMH
NIOSH
NIP
NLC
NLRB
NMT
NP
NPDB
NPI
NPSF
NPSP
NPSR
NQF
NRC
NRHA
NSNA
NSQIP
NSR
NVPA
National Association of Health Data Organizations
National Association of Insurance Commissioners
National Association of Public Hospitals and Health Systems - represents America's
safety net hospitals and health systems
National Association of Psychiatric Health Systems
National Bioterrorism Hospital Preparedness Program
National Board of Medical Examiners
National Board of Osteopathic Medical Examiners
National Board for Respiratory Care
National Coordinating Council for Medication Error Reporting and Prevention
National coverage determination
National Center for Health Statistics
National Center for Health Services Research
National Council Licensure Examination for Registered Nurses
National Committee for Quality Assurance
National Council of State Boards of Nursing
National drug code
National Disaster Medical System
Northeast Human Resources Association
National Emergency Management Association
New England Medical Center
New England Quality Care Alliance
Not-for-profit
National Fire Prevention Association
National Health Service Corp
Neonatal intensive care
Neonatal intensive care unit
National Institutes of Health
National Institute of Mental Health
National Institute for Occupational Safety and Health
National Immunization Program, CDC, DHHS
Nurse Licensure Compact
National Labor Relations Board
Nuclear medicine technologist
Nurse practitioner
National Practitioner Data Bank
National provider identifier
National Patient Safety Foundation
National Patient Safety Partnership
Net Patient Service Revenue
National Quality Forum
Nuclear Regulatory Commission
National Rural Health Association
National Student Nurses Association
National surgical quality improvement program
Nurse Staffing Ratios
National Volunteer Protection Act of 1997
12
Oo
OASIS
OB-GYN
OBRA
OCR
OD
OBS
OHS
OIG
OMB
ONC
ONL
OPO
OPP
OPPS
OR
ORHP
OSHA
OT
OTC
Pp
P4P
PA
PAC
PACE
PAE
PAPE
PASRR
PAT
PBM
PCC
PCCM
PCL
PCMH
PCN
PCP
PCS
PDL
PDN
PDS
PEPM
PEPPER
PET
PGSP
PharmD
PHI
PHO
Outcome and assessment information set
Obstetrics and gynecology
Omnibus Budget Reconciliation Act
U.S. Office of Civil Rights
Optometry doctor
Office-based surgery
U.S. Office of Homeland Security
Office of Inspector General
U.S. Office of Management and Budget
Office of the National Coordinator for Health Information Technology
Organization of Nurse Leaders of Massachusetts and Rhode Island
Organ procurement organization
Office of Patient Protection (state)
Outpatient prospective payment system
Operating room
Office of Rural Health Policy
Occupational Safety and Health Administration
Occupational therapy/therapist
Over-the-counter
Pay for Performance
Physician assistant
Political action committee
Program of all-inclusive care for the elderly; People Acting in Community Endeavors
Preadmission evaluation
Payment amount per episode – MassHealth’s standard payment rate for all outpatient
services
Preadmission screening and resident review
Preadmission testing
Pharmacy benefits manager
Primary care clinician
Primary care case management
www.PatientCareLink.org
Patient-centered medical home
Primary care network
Primary care physician
Patient Care System (HIT)
Preferred drug list
Private duty nurse
Patient data system
Per employee per month
Program for evaluating payment patterns electronic report
Positron emission tomography
Potential Gross State Product
Doctor of pharmacy
Personal health information
Physician hospital organization
13
PHP
PHSA
PHSBPRA
PIP
PMPM
POA
POS
PPACA
PPC
PPO
PPR
PPS
PQRI
PRI
PRO
ProPAC
PSA
PSC
PSI
PSO
PsyD
PT
PU
Qq
QA
QAPI
QI
QIO
QIP
QM
QMB
Qsource
Rr
R&C
R/E/L
RAC
RBPO
RBRVS
RCA
RDRG
REC
Partial hospitalization program
Prepaid health plan
Public Health Service Act
Public Health Security & Bioterrorism Preparedness & Response Act
Periodic interim payment
Performance improvement plan
Per member per month
Present on admission
Point-of-service
Patient Protection and Affordable Care Act
Provider preventable condition
Preferred provider organization
Potentially preventable readmissions
Prospective payment system
Physician quality reporting initiative
Payment reform initiative
Peer review organization
Prospective Payment Assessment Commission
Patient Safety Act
Program safeguard contractor
Patient safety indicator
Patient safety organization
Provider safety organization
Provider-sponsored organization
Doctor of psychology
Physical therapy/therapist
Pressure ulcer
Quality assurance
Quality assessment and performance improvement
Quality improvement
Quality improvement organization
Quality improvement program
Quality management
Qualifying medical bills
Qualified Medicare beneficiary
Center for Healthcare Quality
Reasonable and customary
Racial, ethnicity, and primary language data (Since January 2007, Massachusetts has
mandated that all hospitals report detailed race and ethnicity information on every
patient discharge.)
Medicare's Recovery Audit Contractor Program
Risk-bearing provider organization
Resource-based relative value scale
Root cause analysis
Refined diagnosis-related group
Regional Extension Center
14
RFA
RW
RWJF
RY
Regulatory Flexibility Act
Request for Application
Request for Information
Radio Frequency Identification
Request for proposal
Regional hospital coordinator
Rural health clinic
Regional health information organization
Reporting hospital quality data for annual payment update
Regional mental health institute
Retired municipal teacher (term used by GIC)
Registered nurse
Registered Nurse First Assistants
Return on investment
Regional Policy Board (AHA)
Rural primary care hospital
Rural referral center
Rapid response team
Radiologic technologist
Respiratory therapist
Resource utilization group
Relative value scale
Relative value unit – used by hospitals and physicians groups to calculate compensation
for staff by using a set formula tied to various physician services
Reform Watch
Robert Wood Johnson Foundation
Rate year
Ss
SARS
SB
SCH
SCHIP
SCIP
SCOF
SCOPA
SCPPRR
SCPPV
SEIU
SFR
SFY
SHAEF
SHIP
SHP
SHRM
SHSMD
SICU
SIDS
SII
SME
Severe acute respiratory syndrome
Senate bill
Sole community hospital
State children’s health insurance program
Surgical care improvement project
Standing Committee on Health Care Finance (MHA)
Standing Committee on Public Affairs (MHA)
Special Commission on Public Payer Reimbursement Rates (state)
Special Commission on Provider Price Variation
Service Employees International Union
Substantial financial risk
State fiscal year
State Hospital Association Executive Forum (AHA)
State health insurance assistant program
State health plan
Society of Human Resource Management
Society for Healthcare Strategy & Market Development (AHA)
Surgical intensive care unit
Sudden infant death syndrome
Standards improvement initiative
Subject matter expert
RFI
RFID
RFP
RHC
RHIO
RHQDAPU
RMHI
RMT
RN
RNFA
ROI
RPB
RPCH
RRC
RRT
RT
RUG
RVS
RVU
15
SNF
SPAD
SPD
SPMI
SRE
SREMAC
SSA
SSI
ST
StAAR
SW
Tt
TAG
TANF
TEFRA
TPA
Skilled nursing facility
Standard amount per discharge – inpatient rate paid by MassHealth
Summary plan description
Severely and persistently mentally ill
Serious Reportable Events
Southern Regional Emergency Management Assistance Compact
Social Security Administration
Social Security Act
Supplemental security income
Surgical site infection
Surgical technologist
State Action on Avoidable Rehospitalizations - multi-state, multi-stakeholder initiative
to improve care transitions and reduce avoidable hospital readmissions
Social worker
TPL
TQI
TAC
TME
TPMSPHA
Technical advisory group
Temporary assistance for needy families
Tax Equity and Fiscal Responsibility Act of 1982
Third-party administrator
Tissue plasminogen activator
Third-party liability
Total quality improvement
Trustee Advisory Committee (MHA)
Total Medical Expenses - defined in MA Senate Bill 2585 §11
Turning Point Model State Public Health Act
Uu
UAP
UB-92
UB-04
UCP
UCR
UDNR
UIRS
UNOS
UPL
UR
URAC
USP
UTI
Unlicensed Assistive Personnel
Uniform billing form of 1992
Uniform billing form 2004
Uncompensated Care Pool (uninsured)
Usual, customary and reasonable charges
Universal do not resuscitate
Unusual incident reporting system
United Network for Organ Sharing
Upper Payment Limit
Utilization review
Utilization Review Accreditation Commission
United States Pharmacopeia
Urinary tract infection
Vv
VA
VAP
VBAC
VBP
VHA
Veterans Administration
Ventilator-associated pneumonia
Vaginal birth after cesarean-section
Value-based purchasing
(formerly)Voluntary Hospitals of America- grouping non-profit hospitals to leverage
supply/distributor contracts and build efficiencies
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VHP
VTE
Ww
WHO
WHPPD
WIC
Volunteer health professional
Venous thromboembolism
World Health Organization
Worked hours per patient day - number of hours of direct nursing care a patient can
expect to receive in a 24-hour period
Women and Infant Children Program
Xx
Yy
Zz
ZPIC
Zone program integrity contractor
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