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Glossary of terms

Posted on 12/11/2013, 2:18 PM

Affordable Care Act: The Patient Protection and Affordable Care Act (ACA) (sometimes referred to as Obamacare) was signed into law on March 23, 2010. Goals include expanding public and private insurance to legal U.S. residents and reducing the cost of health care. The act changes how some hospitals receive federal payments and requires hospitals to meet certain quality standards.

Medicare: Provides basic federal health insurance to people who are 65 or older, certain younger people with disabilities, and people with permanent kidney failure.

Medicaid: Provides health care to children, pregnant woman, parents, seniors and individuals with disabilities. Eligibility for coverage is based on income and generally serves the poor and working poor. Funded by the federal government, but administered through state governments.

Sequestration: Refers to automatic federal spending cuts that went into effect on March 1, 2013, as a result of the Budget Control Act of 2011.

Volume-based purchasing: Health care payments paid per service performed.

Value-based purchasing: Health care payments based on quality standards and patient outcomes.

Health Engagement Network: Organizations designed to help identify solutions to reduce hospital acquired conditions and readmissions and spread those best practices to hospitals and other health care providers.

Accountable Care Organization: Groups of doctors, hospitals and other health care providers who come together to voluntarily give coordinated care to Medicare patients.

Primary care provider: A health care provider who is the first point of consultation for patients. Includes family practice physicians, physician assistants and nurse practioners.

Patient days: A standard measure of volume for hospitals. One patient day equals roughly one day of stay for one patient.

Critical Access Hospital: Rural community hospitals that receive cost-based reimbursements. Among other factors, CAH designation is based on size and location.

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