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Common Terms & Acronyms
(ACO) Accountable Care Organization is a network of doctors and hospitals that shares responsibility for providing care to patients. Under the Affordable Care Act, an ACO would agree to manage all of the health care needs of a minimum of 5,000 Medicare beneficiaries for at least three years.
(AHCA) Agency for Health Care Administration is the chief health policy and planning entity for the state of Florida.
(CMS) Centers for Medicare and Medicaid Services is a federal agency within the United States Department of Health and Human Services (DHHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children’s Health Insurance Program (SCHIP), and health insurance portability standards.
(DOH) Department of Health promotes and protects the health and safety of all Floridians.
(DSM) Direct Service Messaging is a secure, encrypted email service that enables users to send and receive messages and attachments containing protected health information. DSM does not require the use of any special software and is free for providers. An internet browser is all that is needed to access DSM
(EHR) Electronic Health Records is an official health record for an individual that is shared among multiple facilities and agencies. Digitized health information systems are expected to improve efficiency and quality of care and, ultimately, reduce costs.
(EPs) Elements of Performance the performance expectations, structures, and processes that are necessary for a facility to have in place in order to provide a high level of care, treatment, and service.
(HEDIS) Healthcare Effectiveness Data and Information Set is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service. Altogether, HEDIS consists of 80 measures across 5 domains of care. Because so many plans collect HEDIS data, and because the measures are so specifically defined, HEDIS makes it possible to compare the performance of health plans on an “apples-to-apples” basis. Health plans also use HEDIS results themselves to see where they need to focus their improvement efforts.
(HIE) Health Information Exchange is the mobilization of healthcare information electronically across organizations within a region, community or hospital system.
(HIPAA) Health Insurance Portability and Accountability ACT The HIPAA Privacy regulations were passed by Congress in 1996. It requires health care providers and organizations, as well as their business associates, to develop and follow procedures that ensure the confidentiality and security of protected health information (PHI) when it is transferred, received, handled, or shared. This applies to all forms of PHI, including paper, oral, and electronic, etc. Furthermore, only the minimum health information necessary to conduct business is to be used or shared.
(HIT) Health Information Technology involves the exchange of health information in an electronic environment. Widespread use of health IT within the health care industry will improve the quality of health care, prevent medical errors, reduce health care costs, increase administrative efficiencies, decrease paperwork, and expand access to affordable health care. It is imperative that the privacy and security of electronic health information be ensured as this information is maintained and transmitted electronically.
(HITECH Act) Health Information Technology for Economic and Clinical Health ActThis legislation was included in the American Recovery and Reinvestment Act (ARRA or Act) to accomplish four major goals that advance the use of health information technology (Health IT). The government will take a leadership role in developing standards by 2010 that allow for the nationwide electronic exchange and use of health information to improve quality and coordination of care. The legislation included $20 billion in health information technology infrastructure, and Medicare and Medicaid incentives to encourage doctors and hospitals to use Health IT to electronically exchange patients’ health information. This generated savings throughout the health sector through improvements in quality of care and care coordination, and reduced medical errors and duplicative care. The Act strengthened Federal privacy and security laws to protect identifiable health information from misuse as the health care sector increases use of Health IT.
(MH) Medical Home is a team based health care delivery model led by a physician that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes.
(MU) Meaningful Use defines the use of EHR, and related technology within a healthcare organization. Achieving meaningful use also helps determine whether an organization will receive payments from the federal government under either the Medicare EHR Incentive Program or the Medicaid EHR Incentive Program.
(NCQA) The National Committee for Quality Assurance is a not-for-profit organization that is committed to improving health care quality. NCQA has developed quality standards and performance measures for a broad range of health care entities including physicians and the certification of Patient Centered Medical Home (PCMH) Content Experts.
Patient-Centric Care System the bringing together of inputs, delivery, management and organization of services as a means of improving access, quality, user satisfaction and efficiency.
(PLU) Patient Look-Up Service is a “network of networks” that allows participating health care organizations and their affiliated users to query the medical records of other participating health care organizations for individual patient data. A patient’s consent is required before their records can be queried. Queries can be based on a patient’s name, date of birth, Social Security Number, and/or other patient demographics.
Priority Primary Care Providers provides primary care services in the areas of Family Practice, Internal Medicine, Obstetrics and Gynecology, and Pediatrics.
(QIO) Quality Improvement Organizations are private contractors that work under the umbrella of CMS. The mission of the QIO Program is to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries.
(SMHP) State Medicaid HIT Plan The Centers for Medicare and Medicaid Services (CMS) requires each state to have a plan with a common vision of how Medicaid’s provider incentive program will operate in concert with the larger health system and statewide efforts. The plan must include at least four components: a current landscape assessment, a vision of the State’s HIT future, specific actions necessary to implement the incentive payments program, and a HIT road map. The Florida Agency for Health Care Administration (AHCA) is responsible for the development and implementation of this plan.