CHG Acronyms Resource List

Size: px
Start display at page:

Download "CHG Acronyms Resource List"

Transcription

1 CHG s Resource List AAMC AAFP AAHAM AAIHDS AAMA ACA ACGME ACE ACHE ACMQ ACO ACPE ACU AHCA AHIP AHP AHRMM AHRQ AHS AHVRP AMA AMCRA ANA AOA AONE APC APN AQA ARRA ASC ASHE ASHES ASHHRA ASHRM A Association of American Medical Colleges American Academy of Family Physicians American Association for Healthcare Administrative Management American Association of Integrated Healthcare Delivery Systems American Academy of Medical Administrators Affordable Care Act Accreditation Council on Graduate Medical Education Acute Care Episode American College of Healthcare Executives American College of Medical Quality Accountable Care Organization American College of Physician Executives Ambulatory Care Unit American Health Care Association America s Health Insurance Plans Allied Health Professional Association for Healthcare Resource & Materials Management Agency for Healthcare Research Quality American Healthcare Systems Association for Healthcare Volunteers Resource Professionals American Medical Association American Medical Care and Review Association American Nurses Association American Osteopathic Association American Organization of Nurse Executives Ambulatory Patient Classifications Advanced Practice Nurse Ambulatory care Quality Alliance American Recovery and Reinvestment Act Ambulatory Surgical Centers American Society for Healthcare Engineering American Society for Healthcare Environmental Services American Society for Healthcare Human Resources Administration American Society for Healthcare Risk Management 1

2 BCBS BME BMI BP CABG CAE CAD CAH CAHPS CAP CAT CAUTI CCN CCR CCU CDC CDR CDSS CER CFO CHC CHF CHG CHIN CHIP CHNA CI CIN CLABSI CME CMMI CMO CMP CMS CNO COBRA COI B Blue Cross Blue Shield Board of Medical Examiners Body Mass Index Blood Pressure C Coronary Artery Bypass Graft Certified Association Executive Coronary Artery Disease Critical Access Hospital Consumer Assessment of Healthcare Providers and Systems Contract Administration Process Computerized Axial Tomography Catheter-Associated Urinary Tract Infection Community Care Network Cost-to-Charge Ratio Critical Care Unit Centers for Disease Control and Prevention Clinical Data Repository Clinical Decision Support System Comparative effectiveness research Chief Financial Officer Community Health Center Congestive Heart Failure Center for Healthcare Governance Community Health Information Network Children's Health Insurance Program Community Health Needs Assessment Clinical Integration Clinically Integrated Network Central Line-Associated Bloodstream Infection Continuing Medical Education Center for Medicare and Medicaid Innovation Chief Medical Officer Civil Monetary Penalty Centers for Medicare & Medicaid Services Chief Nursing Officer Consolidated Omnibus Budget Reconciliation Act Cost of Illness Analysis 2

3 COMS COO CoP COPD CORF CPOE CPT CQI CRNA CRBSI CT CVD CXO DEA DGME DHS DMD DME DMO DNR DO DOA DOH DOJ DRG DSH DTB DUR DVT Clinical Outcomes Measurement Systems Chief Operating Officer Conditions of Participation Chronic Obstructive Pulmonary Disease Comprehensive Outpatient Rehabilitation Facility Computerized Physician Order Entry Current Procedural Terminology Continuous Quality Improvement Certified Registered Nurse Anesthetist Catheter-Related Bloodstream Infections Computed Tomography Cardiovascular Disease Chief Experience Officer D Drug Enforcement Agency Direct Graduate Medical Education Designated Health Service Doctor of Medical Dentistry Durable Medical Equipment Disease Management Organization Do Not Resuscitate Doctor of Osteopathy Dead On Arrival Department of Health Department of Justice Diagnosis-Related Group Disproportionate Share Hospital Door To Balloon time Drug Utilization Review Deep Vein Thrombosis 3

4 EAH EBM ECF ED EEG EHR EKG ELR EMR EMS EMTALA EPO ER erx FACHE FAH FAHS FDA FFS FICA FMV FOIA FP FPPE FQHC FTC FTE GAO GDP GME GP E Essential Access Hospital Evidence-Based Medicine Extended Care Facility Emergency Department Electroencephalogram Electronic Health Record Electrocardiogram Electronic Lab Reporting Electronic Medical Record Emergency Medical System Emergency Medical Treatment and Active Labor Act Exclusive Provider Organization Emergency Room Electronic Prescribing F Fellow, American College of Healthcare Executives Federation of American Hospitals Federation of American Health Systems Food and Drug Administration Fee For Service Federal Insurance Contribution Act Fair Market Value Freedom Of Information Act Family Practitioner Focused Professional Practice Evaluation Federally Qualified Health Center Federal Trade Commission Full-Time Equivalent G Government Accountability Office Gross Domestic Product Graduate Medical Education General Practitioner 4

5 HAC Hospital Acquired Condition HAI Hospital Acquired Infection HCAHPS Hospital Consumer Assessment of Healthcare Providers and Systems HHA Home Health Agency HHS Department of Health and Human Services HIE Health Information Exchange HIMSS Health Information and Management Systems Society HIPPA Health Insurance Portability and Accountability Act of 1996 HIS Hospital Information System HIT Health Information Technology HIV Human Immunodeficiency Virus HMO Health Maintenance Organization HPOE Hospitals in Pursuit of Excellence HPS Hospital Purchasing Service HQA Hospital Quality Alliance HRET Health Research & Educational Trust HRSA Health Resources and Services Administration HAS Health Savings Account HVBP Hospital Value-Based Purchasing H ICD-10 ICF ICU IEC IFD IHF IHI IOM IOCP IPF IPPS IRB IRF IS ISMP IT I International Classification of Diseases, 10th revision Intermediate Care Facility Intensive Care Unit Institutional Ethics Committee Institute for Diversity in Health Management International Hospital Federation Institute for Healthcare Improvement Institute of Medicine Intensive Outpatient Care Program Inpatient Psychiatric Hospital Inpatient Prospective Payment System Institutional Review Board Inpatient Rehabilitation Facility Information Systems Institute for Safe Medicine Practices Information Technology 5

6 JAMA JAR JCAHO JV LHRP LOS LPN LTCH LTC LTCF LTD MA MAC MCO MCR MDC MDP MedPAC MedPAR MEI MGMA MICU MIP MIS MLP MLR MMIS MOC MRI MRSA MSO J Journal of the American Medical Association Joint Annual Report of Hospitals Joint Commission on Accreditation of Healthcare Organizations Joint Venture Leapfrog Hospital Recognition Program Length Of Stay Licensed Practical Nurse Long-Term Care Hospital Long-Term Care Long-Term Care Facility Long-Term Disability M Medical Assistant Medicare Administrative Contractor Managed Care Organization Medicare Cost Report Major Diagnostic Category Medical Disclosure Panel Medicare Payment Advisory Commission Medicare Payment Analysis and Review Medicare Economic Index Medical Group Management Association Medical Intensive Care Unit Medicare Integrity Program Management Information System Mid-Level Practitioner Medical Loss Ratio Medical Management Information System Maintenance of Certification Magnetic Resonance Imaging Methicillin-Resistant Staphylococcus Aureus Management Service Organization L 6

7 MSP MSSP MTM MUA MUP NACH NAMM NB NBCH NBME NCHL NCQA NDC NEJM NICU NIH NMW NP NPI NQF NRHA OB-GYN OD OIG OP OPC OPPE OPPS OR ORHP OSHA OT OTC Medicare Secondary Payer Medicare Shared Savings Program Medication Therapy Management Medically Underserved Area Medically Underserved Population N National Association of Children s Hospitals North American Medical Management Newborn National Business Coalition on Health National Board of Medical Examiners National Center for Healthcare Leadership National Committee for Quality Assurance National Drug Code New England Journal of Medicine Neonatal Intensive Care Unit National Institutes of Health Nurse Midwife Nurse Practitioner National Provider Identifier National Quality Forum National Rural Health Association O Obstetrics & Gynecology Optometry Doctor Office of Inspector General Outpatient Out Patient Clinic Ongoing Professional Practice Evaluation Outpatient Prospective Payment System Operating Room Office of Rural Health Policy Occupational Safety and Health Administration Occupational Therapist Over-The-Counter 7

8 PA PAAC PACU PCCM PCMH PCP PCORI PDx PET PFS PharmD PHO PHS PMO POS PPRC PPO PPP PPS PQRI PSA PSN PSO Pt PT PwC QA QARI QI QIO QM P Physician Assistant Pre-Anesthesia Assessment Clinic Post Anesthesia Care Unit Primary Care Case Management Patient-Centered Medical Home Primary Care Physician Patient-Centered Outcomes Research Institute Principle Diagnosis Positron Emission Tomography Physician Fee Schedule (Medicare) Doctor of Pharmacy Physician-Hospital Organization Public Health Service Principal Medical Officer Point Of Service Physician Payment Review Commission Preferred Provider Organization Preferred Provider Plan Prospective Payment System Physician Quality Reporting Initiative Patient Safety Alert Provider Sponsored Network Patient Safety Organization Patient Physical Therapy PricewaterhouseCoopers Q Quality Assessment Quality Assurance Reform Initiative Quality Improvement Quality Improvement Organization Quality Management 8

9 RAC RAD RCH RFID RFP RHC RHIO RN ROA ROE ROI RRC RUG RVS RVU R Recovery Audit Contractor Radiation Absorbed Dose Rural Community Hospital Radio Frequency Identification Request For Proposal Rural Health Clinic Regional Health Information Organization Registered Nurse Return On Asset Return On Equity Return On Investment Rural Referral Center Resource Utilization Group Relative Value Scale Relative Value Unit SARS Severe Acute Respiratory Syndrome SB Senate Bill SEIU Service Employees International Union SCH Sole Community Hospital SGR Sustainable Growth Rate SHM Society for Hospital Medicine SHSMD Society for Healthcare Strategy and Market Development SICU Surgical Intensive Care Unit SIDS Sudden Infant Death Syndrome SMDA Safety Medical Devices Act SNF Skilled Nursing Facility SOA / SOX Sarbanes-Oxley Act of 2002 SoC Systems of Care SPECT Single Photon Emission Computed Tomography SSI Social Security Income ST Speech Therapy or Speech Therapist STEMI ST Elevation Myocardial Infarction SVP Senior Vice President S 9

10 TCC THR TJC TJR TKR TPA TQI TQM UIRS UM UPIN UR VAP VBP VOP VPS WC WHO T Total Case Compensation Total Hip Replacement The Joint Commission Total Joint Replacement Total Knee Replacement Third-Party Administrator Total Quality Improvement Total Quality Management U Unusual Incident Reporting System Utilization Management Universal Physician Identification Number Utilization Review V Ventilator Associated Pneumonia Value-Based Purchasing Value Of Production Volume Performance Standards W Workers' Compensation World Health Organization YTD Year-to-Date Y 10

Acronyms AARP. April 21, 2014

Acronyms AARP. April 21, 2014 AAFP AAHAM AAIHDS AAMA AAMC AAPC AARP ABN ABN ACA ACE ACGME ACHE ACMQ ACO ACPE ACS ACU ADPH ADR AF4Q AFMC AHA AHC AHCA AHII AHIMA AHIP AHP AHQI AHRMM AHRQ AHS AHVRP AIDS AlaHA ALJ AMA AMA AMCRA AMT ANA

More information

Acronyms Related to Healthcare

Acronyms Related to Healthcare Acronyms Related to Healthcare A AA anesthesiologist assistant AAHC/URACAmerican Accreditation Healthcare Commission, formerly Utilization Review Accreditation Commission AAPCC Average Adjusted Per Capita

More information

http://health-information.advanceweb.com/editorial/content/printfriendly.aspx?cc=211...

http://health-information.advanceweb.com/editorial/content/printfriendly.aspx?cc=211... Page 1 of 6 HIM Abbreviations ADVANCE explains what all those letters mean. ADVANCE explains what all those letters mean. In HIM, there seems to be an abbreviation for everything--policies, agencies, rules

More information

National Action Plan to Prevent Health Care-Associated Infections: ROAD MAP TO ELIMINATION

National Action Plan to Prevent Health Care-Associated Infections: ROAD MAP TO ELIMINATION National Action Plan to Prevent Health Care-Associated Infections: ROAD MAP TO ELIMINATION 2013 National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination April 2013 http://www.hhs.gov/ash/initiatives/hai/index.html

More information

Idaho Medicaid EHR Incentive Program Acronyms and Terms

Idaho Medicaid EHR Incentive Program Acronyms and Terms Idaho Medicaid EHR Incentive Program Acronyms and Terms Acronym Definition AIU Adopt, Implement, Upgrade ALOS Average Length of Stay ARRA American Recovery and Reinvestment Act of 2009 ATCB Authorized

More information

National Provider Call: Hospital Value-Based Purchasing (VBP) Program

National Provider Call: Hospital Value-Based Purchasing (VBP) Program National Provider Call: Hospital Value-Based Purchasing (VBP) Program Fiscal Year 2016 Overview for Beneficiaries, Providers and Stakeholders Cindy Tourison, MSHI Lead, Hospital Inpatient Quality Reporting

More information

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company?

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Lisa Harvey McPherson RN, MBA, MPPM EMHS Vice President Continuum of Care & Chief Advocacy Officer Disclosures

More information

APPENDIX 1-COMMONLY USED ABBREVIATIONS, ACRONYMS AND TERMS IN LONG-TERM CARE SETTINGS

APPENDIX 1-COMMONLY USED ABBREVIATIONS, ACRONYMS AND TERMS IN LONG-TERM CARE SETTINGS APPENDIX 1-COMMONLY USED ABBREVIATIONS, COMMONLY USED ABBREVIATIONS, ACRONYMS AND TERMS IN LONG-TERM CARE ADE Adverse Drug Event. ADL Activities of Daily Living. ADR Adverse Drug Reaction. AIMS Abnormal

More information

Payment Methodology Grid for Medicare Advantage PFFS/MSA

Payment Methodology Grid for Medicare Advantage PFFS/MSA Payment Methodology Grid for Medicare Advantage PFFS/MSA This applies to SmartValue and Security Choice Private Fee-for-Service (PFFS) plans and SmartSaver and Save Well Medical Savings Account (MSA) plans.

More information

Relevant Quality Measures for Critical Access Hospitals

Relevant Quality Measures for Critical Access Hospitals Policy Brief #5 January 0 Relevant Quality Measures for Critical Access Hospitals Michelle Casey MS, Ira Moscovice PhD, Jill Klingner RN, PhD, Shailendra Prasad MD, MPH University of Minnesota Rural Health

More information

Health Information Technology (IT) Simplified

Health Information Technology (IT) Simplified Health Information Technology (IT) Simplified A glossary of all things Health IT Accountable Care Organizations (ACO) - A group of health care providers who give coordinated care, chronic disease management,

More information

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Disclosures. Overview 3/10/2015

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Disclosures. Overview 3/10/2015 What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Lisa Harvey McPherson RN, MBA, MPPM EMHS Vice President Continuum of Care & Chief Advocacy Officer Disclosures

More information

Navigating CMS Incentive Programs for Eligible Professionals Why It Matters and What You Need to Know. Dr. Paul Mulhausen, CMO

Navigating CMS Incentive Programs for Eligible Professionals Why It Matters and What You Need to Know. Dr. Paul Mulhausen, CMO Navigating CMS Incentive Programs for Eligible Professionals Why It Matters and What You Need to Know Dr. Paul Mulhausen, CMO Objectives Better understand CMS Incentive Programs and payment adjustments

More information

Definitions and Acronyms

Definitions and Acronyms 1. Definitions Definitions and Acronyms ACA Expansion Members means individuals less than 65 years of age with income below 138% of the federal poverty level and former foster children up to the age of

More information

Incident To Services Documentation and Correct Billing July 23 2013 Presented by: Ellen Berra, Outreach Senior Analyst Karen Kroupa, Outreach Analyst

Incident To Services Documentation and Correct Billing July 23 2013 Presented by: Ellen Berra, Outreach Senior Analyst Karen Kroupa, Outreach Analyst Incident To Services Documentation and Correct Billing July 23 2013 Presented by: Ellen Berra, Outreach Senior Analyst Karen Kroupa, Outreach Analyst Agenda Overview Documentation Requirements Part A Part

More information

Value Based Care and Healthcare Reform

Value Based Care and Healthcare Reform Value Based Care and Healthcare Reform Dimensions in Cardiac Care November, 2014 Jacqueline Matthews, RN, MS Senior Director, Quality Reporting & Reform Quality and Patient Safety Institute Cleveland Clinic

More information

Aligning Incentives for Quality: Pharmacy's Role in Achieving Hospital and National Goals. Objectives. National Organizations: Key Linkages

Aligning Incentives for Quality: Pharmacy's Role in Achieving Hospital and National Goals. Objectives. National Organizations: Key Linkages Aligning Incentives for Quality: Pharmacy's Role in Achieving Hospital and National Goals Kasey K. Thompson, Pharm.D. Director, Practice Standards and Quality Division Director, Patient Safety American

More information

Timeline for Health Care Reform

Timeline for Health Care Reform Patient Protection and Affordable Care Act (H.R. 3590) and the Reconciliation Bill (H.R. 4872) March 24, 2010 Color Code: Hospitals Insurance Coverage Other/Workforce Delivery System 2010 Expands the RAC

More information

Quality and Performance Improvement PATRICK SCHULTZ MS RN ACNS BC DIRECTOR OF QUALITY AND PATIENT SAFETY SANFORD MEDICAL CENTER FARGO

Quality and Performance Improvement PATRICK SCHULTZ MS RN ACNS BC DIRECTOR OF QUALITY AND PATIENT SAFETY SANFORD MEDICAL CENTER FARGO Quality and Performance Improvement PATRICK SCHULTZ MS RN ACNS BC DIRECTOR OF QUALITY AND PATIENT SAFETY SANFORD MEDICAL CENTER FARGO Crossing The Quality Chasm: A New Health System For The 21st Century

More information

The PFFS Reimbursement Guide

The PFFS Reimbursement Guide The PFFS Reimbursement Guide SecureHorizons Direct reimburses claims based on Medicare Fee Schedules, Prospective Payment Systems (PPS) and estimated Medicare payments amounts. Payment methodologies are

More information

Continuity of Care Guide for Ambulatory Medical Practices

Continuity of Care Guide for Ambulatory Medical Practices Continuity of Care Guide for Ambulatory Medical Practices www.himss.org t ra n sf o r m i ng he a lth c a re th rou g h IT TM Table of Contents Introduction 3 Roles and Responsibilities 4 List of work/responsibilities

More information

EHR Incentive Payments For Rural Hospitals and Eligible Providers. April, 2011. Tommy Barnhart, Dixon Hughes Goodman LLP

EHR Incentive Payments For Rural Hospitals and Eligible Providers. April, 2011. Tommy Barnhart, Dixon Hughes Goodman LLP EHR Incentive Payments For Rural Hospitals and Eligible Providers April, 2011 Tommy Barnhart, Dixon Hughes Goodman LLP Objectives Health Information Technology (HIT) and Electronic Health Record (EHR)

More information

State HAI Template Utah. 1. Develop or Enhance HAI program infrastructure

State HAI Template Utah. 1. Develop or Enhance HAI program infrastructure State HAI Template Utah 1. Develop or Enhance HAI program infrastructure Successful HAI prevention requires close integration and collaboration with state and local infection prevention activities and

More information

Optimizing Post-Acute Care Services in Population Health April 3, 2013

Optimizing Post-Acute Care Services in Population Health April 3, 2013 Optimizing Post-Acute Care Services in Population Health April 3, 2013 Table of contents Key objectives! Provide background on population health and its impact on PAC providers! Discuss capabilities required

More information

Medicare and Medicaid Programs; EHR Incentive Programs

Medicare and Medicaid Programs; EHR Incentive Programs Medicare and Medicaid Programs; EHR Incentive Programs Background The American Recovery and Reinvestment Act of 2009 establishes incentive payments under the Medicare and Medicaid programs for certain

More information

CMS EHR Incentive Programs

CMS EHR Incentive Programs CMS EHR Incentive Programs Meaningful Use and the ASC CMS Ambulatory Surgical Centers, as an institution, are not eligible for any of the CMS EHR Incentive programs. However, Eligible Professionals that

More information

Disclosure. Meaningful use 2009. Objectives. Meaningful use. Fundamentals of Transitions of Care (TOC)

Disclosure. Meaningful use 2009. Objectives. Meaningful use. Fundamentals of Transitions of Care (TOC) 47 th Annual Meeting August 2-4, 2013 Orlando, FL Fundamentals of Transitions of Care (TOC) Rebecca R. Prevost, B.S., Pharm.D., PSO Medication Safety Officer Florida Hospital Disclosure I do not have a

More information

Health Care Finance 101

Health Care Finance 101 Alaska Health Care Commission Health Care Finance 101 Ken Tonjes CFO PeaceHealth Ketchikan Medical Center June 20, 2013 Basics: Glossary of Terms Common Financial Terminology Gross Charges (Revenue) Total

More information

How Regulations Affect Coding and Documentation

How Regulations Affect Coding and Documentation How Regulations Affect Coding and Documentation Byline Deborah Neville, RHIA, CCS-P Director Revenue Cycle, Coding and Compliance for Elsevier, Inc. INTRODUCTION Regulations, laws, mandates, and guidelines

More information

Broad Issues in Quality Measurement: the CMS perspective

Broad Issues in Quality Measurement: the CMS perspective Broad Issues in Quality Measurement: the CMS perspective Shari M. Ling, MD Deputy Chief Medical Officer Centers for Medicare & Medicaid Services Workshop on Quality Measurement Developing Evidence-Based

More information

June 25, 2012. Dear Acting Administrator Tavenner,

June 25, 2012. Dear Acting Administrator Tavenner, June 25, 2012 Marilyn B. Tavenner, RN, Acting Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Attention: CMS-1588-P P.O. Box 8011 Baltimore, MD 21244-1850

More information

SCORING METHODOLOGY Fall 2015

SCORING METHODOLOGY Fall 2015 SCORING METHODOLOGY Fall 2015 HOSPITAL SAFETY SCORE Contents What is the Hospital Safety Score?... 4 Eligible and Excluded Hospitals... 4 Scoring Methodology... 5 Measures... 5 How Measures are Scored...

More information

What GI Practices Need to Know About the Electronic Health Record Incentive Program. Joel V. Brill, MD, AGAF Lawrence R. Kosinski, MD, MBA, AGAF

What GI Practices Need to Know About the Electronic Health Record Incentive Program. Joel V. Brill, MD, AGAF Lawrence R. Kosinski, MD, MBA, AGAF What GI Practices Need to Know About the Electronic Health Record Incentive Program Joel V. Brill, MD, AGAF Lawrence R. Kosinski, MD, MBA, AGAF Disclosures Joel V. Brill, MD AGAF AGA Registry Executive

More information

Acronyms Used in Text

Acronyms Used in Text Acronyms Used in Text AA associate of arts (degree) AAAHC Accreditation Association for Ambulatory Healthcare AAHSA American Association of Homes and Services for the Aging, also known as LeadingAge AAMC

More information

The Centers for Medicare & Medicaid Services (CMS) Acute Care Hospital Fiscal Year (FY) 2018 Quality Improvement Program Measures

The Centers for Medicare & Medicaid Services (CMS) Acute Care Hospital Fiscal Year (FY) 2018 Quality Improvement Program Measures ID Me asure Name NQF # - (HRRP) ID Me asure Name NQF # - (HRRP) ID Me asure Name NQF # - (HRRP) CMS Measures Fiscal Year 2018 The Centers for Medicare & Medicaid Services (CMS) Acute Care Fiscal Year (FY)

More information

Fiscal Year 2016 proposed Inpatient and Long-term Care Hospital policy and payment changes (CMS-1632-P)

Fiscal Year 2016 proposed Inpatient and Long-term Care Hospital policy and payment changes (CMS-1632-P) Fiscal Year 2016 proposed Inpatient and Long-term Care Hospital policy and payment changes (CMS-1632-P) Date 2015-04-17 Title Fiscal Year 2016 proposed Inpatient and Long-term Care Hospital policy and

More information

Tom Farley, RN, MS, ACNP Hildy Schell, RN, MS, CCNS San Francisco, CA 2010

Tom Farley, RN, MS, ACNP Hildy Schell, RN, MS, CCNS San Francisco, CA 2010 Advanced Health Care Practitioners in Critical Care Tom Farley, RN, MS, ACNP Hildy Schell, RN, MS, CCNS San Francisco, CA 2010 Critical Care Leadership Team Unit or Division Medical Director Patient Care

More information

Medicare Provider Reimbursement Manual

Medicare Provider Reimbursement Manual Medicare Provider Reimbursement Manual Part 2, Provider Cost Reporting Forms and Instructions, Chapter 40, Form CMS 2552-10 Department of Health and Human Services (DHHS) Centers for Medicare and Medicaid

More information

CMS Progress Toward Implementing Value-Based Purchasing

CMS Progress Toward Implementing Value-Based Purchasing Centers for Medicare & Medicaid Services CMS Progress Toward Implementing Value-Based Purchasing Thomas B. Valuck, MD, JD Medical Officer & Senior Adviser Center for Medicare Management Presentation Overview

More information

Accountable Care Organizations An Operational Overview

Accountable Care Organizations An Operational Overview Accountable Care Organizations An Operational Overview Chris Champ Principal cchamp@eidebailly.com 701-239-8620 1 Medicare Spending 2 1 CMS Goal Transition of Risk 60 50 40 30 20 10 0 2015 2016 2018 Percentage

More information

AGENCY-SPECIFIC PLAN FOR THE NATIONAL QUALITY STRATEGY

AGENCY-SPECIFIC PLAN FOR THE NATIONAL QUALITY STRATEGY AGENCY-SPECIFIC PLAN FOR THE NATIONAL QUALITY STRATEGY Adult Medicaid Quality Grants Program The Adult Medicaid Quality Grants Program is a 2-year funding opportunity designed to support grantee Medicaid

More information

QUALITY BEGINNER. PQRS Training Module: QUALITY MEASUREMENT 101. Last Updated: August 2014

QUALITY BEGINNER. PQRS Training Module: QUALITY MEASUREMENT 101. Last Updated: August 2014 QUALITY 01 BEGINNER PQRS Training Module: QUALITY MEASUREMENT 101 Last Updated: August 2014 TRAINING MODULE OBJECTIVES Quality Measurement 101 is a training module for providers who are interested in learning

More information

CMS Progress Toward Implementing Value-Based Purchasing

CMS Progress Toward Implementing Value-Based Purchasing Centers for Medicare & Medicaid Services CMS Progress Toward Implementing Value-Based Purchasing Lisa Grabert, MPH Health Insurance Specialist Hospital & Ambulatory Policy Group Presentation Overview CMS

More information

Medicare Outpatient Therapy Billing

Medicare Outpatient Therapy Billing DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services R Medicare Outpatient Therapy Billing August 2010 / ICN: 903663 DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare

More information

Facility Enrollment Required Document Checklist

Facility Enrollment Required Document Checklist Facility Enrollment Required Document Checklist Facility Classification Ambulatory Infusion Center (AIC) Ambulatory Surgical Facility (ASF) End Stage Renal Disease Facility (ESRD) - Accreditation Commission

More information

Overview of the Hospital Value-Based Purchasing (VBP) Fiscal Year (FY) 2017

Overview of the Hospital Value-Based Purchasing (VBP) Fiscal Year (FY) 2017 Overview of the Hospital Value-Based Purchasing (VBP) Fiscal Year (FY) 2017 Bethany Wheeler Hospital VBP Program Support Contract Lead HSAG February 17, 2015 2 p.m. ET Purpose This event will provide an

More information

Covered Service Description

Covered Service Description Advanced registered nurse practitioner (ARNP) Ambulatory surgical center (ASC) These are given by an ARNP who s licensed to practice in the State of Florida The ARNP and a doctor must make decisions about

More information

Improving Hospital Performance

Improving Hospital Performance Improving Hospital Performance Background AHA View Putting patients first ensuring their care is centered on the individual, rooted in best practices and utilizes the latest evidence-based medicine is

More information

Using Medicare Hospitalization Information and the MedPAR. Beth Virnig, Ph.D. Associate Dean for Research and Professor University of Minnesota

Using Medicare Hospitalization Information and the MedPAR. Beth Virnig, Ph.D. Associate Dean for Research and Professor University of Minnesota Using Medicare Hospitalization Information and the MedPAR Beth Virnig, Ph.D. Associate Dean for Research and Professor University of Minnesota MedPAR Medicare Provider Analysis and Review Includes information

More information

Accountable Care Organizations

Accountable Care Organizations Accountable Care Organizations Myth, Reality, Facts Why =System Failure Low Quality - IOM report High Cost Quality Cost disconnect Low Value Problems Disconnect between Quality and Cost Care is fragmented

More information

COMMUNITY HEALTH CARE REPORT May 2015

COMMUNITY HEALTH CARE REPORT May 2015 COMMUNITY HEALTH CARE REPORT May 2015 CONTACT Loretto Hospital Marketing & Communications Department 645 S. Central Avenue Chicago, IL 60644 Phone: (773) 626-4300; Fax: (773) 854-5542 Email: Marketing@lorettohospital.org

More information

09-14 FORM CMS-2552-10 4004 4004. WORKSHEET S-2 - HOSPITAL AND HOSPITAL HEALTH CARE COMPLEX IDENTIFICATION DATA This worksheet consists of two parts:

09-14 FORM CMS-2552-10 4004 4004. WORKSHEET S-2 - HOSPITAL AND HOSPITAL HEALTH CARE COMPLEX IDENTIFICATION DATA This worksheet consists of two parts: 09-14 FORM CMS-2552-10 4004 4004. WORKSHEET S-2 - HOSPITAL AND HOSPITAL HEALTH CARE COMPLEX IDENTIFICATION DATA This worksheet consists of two parts: Part I - Hospital and Hospital Health Care Complex

More information

Critical Access Hospitals and

Critical Access Hospitals and Critical Access Hospitals and Health Care Reform What s in it for you? Patient Protection and Affordable Care Act (ACA) Fundamental changes Moving Medicare from payment for services to payment for outcomes

More information

27. Will the plan pay for radiology done in the provider s office?... 10 28. How do providers request assistance with care management issues?...

27. Will the plan pay for radiology done in the provider s office?... 10 28. How do providers request assistance with care management issues?... Provider Q&A Contents 1. Who is Florida True Health?... 3 2. What is the new product name?... 3 3. Does the plan have a website?... 3 4. How will physicians be paid? (FFS or capitation)... 3 5. What clearing

More information

Oregon Health Authority Division of Medical Assistance Programs Revenue Center Code Table

Oregon Health Authority Division of Medical Assistance Programs Revenue Center Code Table 11X ROOM AND BOARD PRIVATE (MEDICAL OR GENERAL) 110# 111# 112# 113# 114# 115 116# 117# 118# 119# Medical/Surgical/Gyn OB Pediatric Psychiatric Hospice (Not Covered) Detoxification Oncology Rehab/Private

More information

Outpatient Hospital and Ambulatory Surgical Center Services

Outpatient Hospital and Ambulatory Surgical Center Services INDIANA HEALTH COVERAGE PROGRAMS PROVIDER REFERENCE M ODULE Outpatient Hospital and Ambulatory Surgical Center Services L I B R A R Y R E F E R E N C E N U M B E R : P R O M O D 0 0 0 4 1 P U B L I S H

More information

Summary of Health Information Technology Incentives and Resources

Summary of Health Information Technology Incentives and Resources Summary of Health Information Technology Incentives and Resources February 2011 This is a publication of the Technical Assistance and Services Center (TASC), a program of the National Rural Health Resource

More information

Proving Respiratory Therapy value in the Affordable Care Pay Structure

Proving Respiratory Therapy value in the Affordable Care Pay Structure Proving Respiratory Therapy value in the Affordable Care Pay Structure The Curve 2 2 No Margin No Mission (FFS) Outcomes 3 * 2001 study in five states found that medical debt contributed to 46.2% of all

More information

What is an ACO? What forms of organizations may become an ACO? IAMSS 30 th Annual Education Conference Pearls of Wisdom

What is an ACO? What forms of organizations may become an ACO? IAMSS 30 th Annual Education Conference Pearls of Wisdom IAMSS 30 th Annual Education Conference Pearls of Wisdom The Impact of Accountable Care Organizations (ACOs) and Health Care Reform on Credentialing, Privileging and Peer Review April 28-29, 2011 Michael

More information

Glossary. Adults: Individuals ages 19 through 64. Allowed amounts: See prices paid. Allowed costs: See prices paid.

Glossary. Adults: Individuals ages 19 through 64. Allowed amounts: See prices paid. Allowed costs: See prices paid. Glossary Acute inpatient: A subservice category of the inpatient facility clams that have excluded skilled nursing facilities (SNF), hospice, and ungroupable claims. This subcategory was previously known

More information

Payment by Provider Type for MedicareBlue PPO Covered Services...3

Payment by Provider Type for MedicareBlue PPO Covered Services...3 Payment by Provider Type...2 Dual Eligibility and MedicareBlue PPO...2 Payments for Medicare Incentive Programs...2 General Claims Submission Guidelines...2 Payment by Provider Type for MedicareBlue PPO

More information

Preface. Summary of Changes. Table of Contents. Service Contacts. October 2014 Replaces: May 2014 S-5781 10/14

Preface. Summary of Changes. Table of Contents. Service Contacts. October 2014 Replaces: May 2014 S-5781 10/14 Preface Summary of Changes Table of Contents Service Contacts October 2014 Replaces: May 2014 S-5781 10/14 Preface The Wellmark Provider Guide and specialty guides are billing resources for providers doing

More information

The Vermont Healthcare Associated Infection Prevention Plan

The Vermont Healthcare Associated Infection Prevention Plan The Vermont Healthcare Associated Infection Prevention Plan Submitted to the Centers for Disease Control and Prevention on January 1, 2010 This plan was developed through a collaborative effort of the

More information

Coverage and Recreation Therapy Services

Coverage and Recreation Therapy Services Coverage and Recreation Therapy Services Mary Lou Schilling, Ph.D., CTRS Associate Professor, Central Michigan University Past President, Central Rehabilitation Services, Inc. Session goals: Upon completion

More information

Jane Snecinski Post Acute Advisors, LLC P.O. Box 12078 Atlanta, GA 30355 www.postacuteadvisors.com. RAC National Summit

Jane Snecinski Post Acute Advisors, LLC P.O. Box 12078 Atlanta, GA 30355 www.postacuteadvisors.com. RAC National Summit Jane Snecinski P.O. Box 12078 Atlanta, GA 30355 www.postacuteadvisors.com RAC National Summit Inpatient Rehab Patients Not Meeting Medical Necessity Criteria Late Submissions of PAI Outpatient Therapy

More information

Summary of the Proposed Rule for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Program (Eligible Professionals only)

Summary of the Proposed Rule for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Program (Eligible Professionals only) Summary of the Proposed Rule for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Program (Eligible Professionals only) Background Enacted on February 17, 2009, the American Recovery

More information

ZEPHYRLIFE REMOTE PATIENT MONITORING REIMBURSEMENT REFERENCE GUIDE

ZEPHYRLIFE REMOTE PATIENT MONITORING REIMBURSEMENT REFERENCE GUIDE ZEPHYRLIFE REMOTE PATIENT MONITORING REIMBURSEMENT REFERENCE GUIDE Overview This guide includes an overview of Medicare reimbursement methodologies and potential coding options for the use of select remote

More information

Proven Innovations in Primary Care Practice

Proven Innovations in Primary Care Practice Proven Innovations in Primary Care Practice October 14, 2014 The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. 2014 Society for Healthcare

More information

CMS is requesting information to aid in the planning and implementation of the MIPS in the following areas:

CMS is requesting information to aid in the planning and implementation of the MIPS in the following areas: Summary of Medicare s Request for Information on the Provisions in MACRA which Allow for Implementation of Alternative Payment Models and a Merit-Based Incentive Payment System On September 28, 2015, the

More information

CMMI Payment Bundling Initiative

CMMI Payment Bundling Initiative CMMI Payment Bundling Initiative Table of Contents Questions & Answers... 2 Technical... 2 General... 3 Inpatient... 12 Skilled Nursing Facility (SNF)... 18 Outpatient... 20 Home Health... 23 Carrier...

More information

Value Based Insurance Design Key concepts & their application at HealthPartners Health Insurance Plan

Value Based Insurance Design Key concepts & their application at HealthPartners Health Insurance Plan Value Based Insurance Design Key concepts & their application at HealthPartners Health Insurance Plan Shaun Frost, MD Associate Medical Director for Care Delivery Systems HealthPartners Health Plan Minneapolis,

More information

FY 2016 Inpatient PPS Proposed Rule Quality Issues May 21, 2015

FY 2016 Inpatient PPS Proposed Rule Quality Issues May 21, 2015 FY 2016 Inpatient PPS Proposed Rule Quality Issues May 21, 2015 AAMC Staff: Scott Wetzel, swetzel@aamc.org Mary Wheatley, mwheatley@aamc.org Agenda Summary of key quality and payment IPPS provisions Cross-cutting

More information

Inpatient Rehabilitation Facility Quality Reporting Program Train-the-Trainer Conference. May 2, 2012. Centers for Medicare & Medicaid Services 1

Inpatient Rehabilitation Facility Quality Reporting Program Train-the-Trainer Conference. May 2, 2012. Centers for Medicare & Medicaid Services 1 Division of National Systems Operationalizing Data Submission for ACA Section 3004 Stacy Mandl, RN Division of National Systems Who Are We? The Division of National Systems is located within the Data and

More information

Meaningful Use Updates. HIT Summit September 19, 2015

Meaningful Use Updates. HIT Summit September 19, 2015 Meaningful Use Updates HIT Summit September 19, 2015 Meaningful Use Updates Nadine Owen, BS,CHTS-IS, CHTS-IM Health IT Analyst Hawaii Health Information Exchange No other relevant financial disclosures.

More information

Medicare Long-Term Care Hospital Prospective Payment System

Medicare Long-Term Care Hospital Prospective Payment System Medicare Long-Term Care Hospital Prospective Payment System Payment Rule Brief PROPOSED RULE Program Year: FFY 2015 Overview, Resources, and Comment Submission On May 15, the Centers for Medicare and Medicaid

More information

U.S. Department of Health & Human Services May 7, 2014. New HHS Data Shows Major Strides Made in Patient Safety, Leading to Improved Care and Savings

U.S. Department of Health & Human Services May 7, 2014. New HHS Data Shows Major Strides Made in Patient Safety, Leading to Improved Care and Savings U.S. Department of Health & Human Services May 7, 2014 New HHS Data Shows Major Strides Made in Patient Safety, Leading to Improved Care and Savings The data in this report shows a substantial nine percent

More information

Funding for Clinical Services in Academic Departments in the World of ACOs and Health Care Reform

Funding for Clinical Services in Academic Departments in the World of ACOs and Health Care Reform Funding for Clinical Services in Academic Departments in the World of ACOs and Health Care Reform 2015 Association of Professors of Dermatology Annual Meeting Atul Grover, M.D., Ph.D. Chief Public Policy

More information

Insurance 101. Infant and Toddler Coordinators Association. July 28, 2012 Capital City Hyatt. Laura Pizza Plum Plum Healthcare Consulting

Insurance 101. Infant and Toddler Coordinators Association. July 28, 2012 Capital City Hyatt. Laura Pizza Plum Plum Healthcare Consulting Insurance 101 Infant and Toddler Coordinators Association July 28, 2012 Capital City Hyatt Laura Pizza Plum 1 Agenda Basics of Health Insurance Frequently Asked Questions Early Intervention and working

More information

2/20/2014. Joette Derricks, CPC, CHC, CMPE, CSSGB, CLHC Vice-President, Regulatory Affairs & Research Anesthesia Business Consultants

2/20/2014. Joette Derricks, CPC, CHC, CMPE, CSSGB, CLHC Vice-President, Regulatory Affairs & Research Anesthesia Business Consultants Joette Derricks, CPC, CHC, CMPE, CSSGB, CLHC Vice-President, Regulatory Affairs & Research Anesthesia Business Consultants Neda M. Ryan, Attorney, Clark Hill PLC Anesthesia Business Consultants, Clark

More information

Comparison of the Prospective Payment System Methodologies Currently Utilized in the United States

Comparison of the Prospective Payment System Methodologies Currently Utilized in the United States Comparison of the Prospective Payment System Methodologies Currently Utilized in the United States 1 Can you speak the jargon of Prospective Payment Systems? MS- DRGs APCs IPF-PPS RBRVS HHRGs RUGs MS-LTC

More information

MaineCare Value Based Purchasing Initiative

MaineCare Value Based Purchasing Initiative MaineCare Value Based Purchasing Initiative The Accountable Communities Strategy Jim Leonard, Deputy Director, MaineCare Peter Kraut, Acting Accountable Communities Program Manager Why Value-Based Purchasing

More information

Medicare Inpatient Rehabilitation Facility Prospective Payment System

Medicare Inpatient Rehabilitation Facility Prospective Payment System Medicare Inpatient Rehabilitation Facility Prospective Payment System Payment Rule Brief FINAL RULE Program Year: FFY 2015 Overview and Resources On August 6, 2014, the Centers for Medicare and Medicaid

More information

HIT Incentives: CMS Proposed Meaningful Use Rule and ONC Interim Final Rule on Standards and Certification

HIT Incentives: CMS Proposed Meaningful Use Rule and ONC Interim Final Rule on Standards and Certification HIT Incentives: CMS Proposed Meaningful Use Rule and ONC Interim Final Rule on Standards and Certification Ivy Baer, J.D., M.P.H. Director & Regulatory Counsel ibaer@aamc.org; 202-828-0499 Lori Mihalich-Levin,

More information

Custom Report Data Elements: Hospital Database Fields

Custom Report Data Elements: Hospital Database Fields Custom Report Data Elements: Hospital Database Fields Data Sources: AHA Annual Survey of Hospitals; American Hospital Association membership database; United States Census Bureau; accrediting organizations.

More information

CMS PQRS and VBPM Incentive/Penalty Programs. Devin Detwiler Manager Quality Improvement Telligen

CMS PQRS and VBPM Incentive/Penalty Programs. Devin Detwiler Manager Quality Improvement Telligen CMS PQRS and VBPM Incentive/Penalty Programs Devin Detwiler Manager Quality Improvement Telligen Free Resource to you Join our Network Engage providers and stakeholders in improvement initiatives through

More information

Incident to Billing. Presented by: Helen Hadley VantagePoint Health Care Advisors

Incident to Billing. Presented by: Helen Hadley VantagePoint Health Care Advisors Incident to Billing Presented by: Helen Hadley VantagePoint Health Care Advisors Outline 11 Who Are Non-Physician Practitioners? 22 What are incident-to rules? 33 What are the 3 supervision categories?

More information

The Impact of Value- Based Purchasing in the Healthcare Industry

The Impact of Value- Based Purchasing in the Healthcare Industry The Impact of Value- Based Purchasing in the Healthcare Industry Presented By: Kim Charland, BA, RHIT, CCS Senior Vice President Clinical Innovation for Panacea Healthcare Solutions and Editor of VBPmonitor

More information

Regulatory Compliance Policy No. COMP-RCC 4.07 Title:

Regulatory Compliance Policy No. COMP-RCC 4.07 Title: I. SCOPE: Regulatory Compliance Policy No. COMP-RCC 4.07 Page: 1 of 7 This policy applies to (1) any Hospital in which Tenet Healthcare Corporation or an affiliate owns a direct or indirect equity interest

More information

THE CENTERS FOR MEDICARE & MEDICAID SERVICES QUALITY IMPROVEMENT ROADMAP

THE CENTERS FOR MEDICARE & MEDICAID SERVICES QUALITY IMPROVEMENT ROADMAP THE CENTERS FOR MEDICARE & MEDICAID SERVICES QUALITY IMPROVEMENT ROADMAP July 2005 EXECUTIVE SUMMARY VISION: The right care for every person every time. AIMS: Make care safe, effective, efficient, patient-centered,

More information

Informational Series. Community TM. Glossary of Health Insurance & Medical Terminology. (855) 624-6463 HealthOptions.

Informational Series. Community TM. Glossary of Health Insurance & Medical Terminology. (855) 624-6463 HealthOptions. Informational Series Glossary of Health Insurance & Medical Terminology How to use this glossary This glossary has many commonly used terms, but isn t a full list. These glossary terms and definitions

More information

CMS Quality Measurement and Value Based Purchasing Programs Kate Goodrich, MD MHS Director, Quality Measurement and Health Assessment Group, CMS

CMS Quality Measurement and Value Based Purchasing Programs Kate Goodrich, MD MHS Director, Quality Measurement and Health Assessment Group, CMS CMS Quality Measurement and Value Based Purchasing Programs Kate Goodrich, MD MHS Director, Quality Measurement and Health Assessment Group, CMS American Urological Association Quality Improvement Summit

More information

Current Medicare Fee-for-Service Pay-for-Performance Initiatives for Hospital and Physician Services. July 13, 2015

Current Medicare Fee-for-Service Pay-for-Performance Initiatives for Hospital and Physician Services. July 13, 2015 Current Medicare Fee-for-Service Pay-for-Performance Initiatives for Hospital and Physician Services July 13, 2015 Broad Overview of Payment Policy Direction Current State Future State Current mandatory

More information

UPDATED NOVEMBER 2015. Providing and Billing Medicare for Chronic Care Management

UPDATED NOVEMBER 2015. Providing and Billing Medicare for Chronic Care Management UPDATED NOVEMBER 2015 Providing and Billing Medicare for Chronic Care Management Research studies have demonstrated time and again that care management reduces total costs of care for chronic disease patients

More information

Medicare Inpatient Rehabilitation Facility Prospective Payment System

Medicare Inpatient Rehabilitation Facility Prospective Payment System Medicare Inpatient Rehabilitation Facility Prospective Payment System Payment Rule Brief PROPOSED RULE Program Year: FFY 2015 Overview, Resources, and Comment Submission On May 7, 2014, the Centers for

More information

EHR Incentive Payments Medicare and Medicaid Indiana

EHR Incentive Payments Medicare and Medicaid Indiana EHR Incentive Payments Medicare and Medicaid Indiana OPTIMIZING EHR PAYMENTS William Rees, CPA Director 317-713-7942 brees@blueandco.com EHR Regulations EHR Incentive Legislation: American Recovery and

More information

Physicians, EHR Stimulus and Healthcare Reform

Physicians, EHR Stimulus and Healthcare Reform Physicians, EHR Stimulus and Healthcare Reform The Physicians Foundation is proud to present this webinar on the evolving world of EHRs and office practice as part of its mission to improve the care, quality

More information

Healthy Indiana Plan Reimbursement Manual

Healthy Indiana Plan Reimbursement Manual HP Managed Care Unit INDIANA HEALTH COVERAGE PROGRAMS Healthy Indiana Plan Reimbursement Manual L I B R A R Y R E F E R E N C E N U M B E R : P R H P 1 0 0 0 1 P O L I C I E S A N D P R O C E D U R E S

More information

ALL TEXAS MEDICAID FEE SCHEDULES ARE AVAILABLE AT THE FOLLOWING LINK: www.tmhp.com

ALL TEXAS MEDICAID FEE SCHEDULES ARE AVAILABLE AT THE FOLLOWING LINK: www.tmhp.com User s Guide to SECTION FOUR Page 25 ALL TEXAS MEDICAID FEE SCHEDULES ARE AVAILABLE AT THE FOLLOWING LINK: www.tmhp.com The Texas Medicaid Fee Schedule is categorized by field descriptions. () codes are

More information

OPTIMIZING THE USE OF YOUR ELECTRONIC HEALTH RECORD. A collaborative training offered by Highmark and the Pittsburgh Regional Health Initiative

OPTIMIZING THE USE OF YOUR ELECTRONIC HEALTH RECORD. A collaborative training offered by Highmark and the Pittsburgh Regional Health Initiative OPTIMIZING THE USE OF YOUR ELECTRONIC HEALTH RECORD A collaborative training offered by Highmark and the Pittsburgh Regional Health Initiative Introductions Disclosures Successful completion of training

More information