Common Healthcare Acronyms
ACA –Affordable Care Act
ACI – Advancing Care Information, also see meaningful use
ACO – Accountable Care Organization, also see MSSP
AHRQ - Agency for Healthcare Research and Quality
Advanced APM – Advanced Alternative Payment Model
APM – Alternative Payment Model
ASC – Ambulatory Surgery Center
ASPE – Office of the Assistant Secretary for Plan
BPCI - Bundled Payments for Care Improvement
BPCI-A -Bundled Payments for Care Improvement Advanced
CEHRT – Certified Electronic Health Record Technology
CFR – Code of Federal Regulations
CHIP – Children’s Health Insurance Program
CIN – Clinically Integrated Network
CJR – Comprehensive Care for Joint Replacement model
CME – Continuing medical education
CMMI - Center for Medicare & Medicaid Innovation (Innovation Center)
CMS – Centers for Medicare & Medicaid Services
CPC+ - Comprehensive Primary Care Plus
CPCI - Comprehensive Primary Care Initiative
CPI – Consumer Price Index
CPR - Customary, Prevailing, and Reasonable
CPIA – Clinical Practice Improvement Activities
CPS - Composite Performance Score
CPT – Current procedural terminology
CQM – Clinical quality measure
CY – Calendar Year
DEA – Drug Enforcement Administration
DME – Durable Medical Equipment
DOJ – Department of Justice
DRG – Diagnosis-related group
DSH - Disproportionate share hospital
eCQM – Electronically specified clinical quality measure
EHR – Electronic health record
E&M – Evaluation and Management Services
EMR –Electronic Medical Record
EPs – Eligible professionals
eRx – Electronic prescribing
FDA – Food and Drug Administration
FFS – Fee-for-service
FQHC - Federally Qualified Health Center
FY – Fiscal year
GAO – Government Accountability Office
GME – Graduate medical education
GPCI - Geographic practice cost index
GPRO – Group Practice Reporting Option
HAC – Hospital-Acquired Condition
HAI – Hospital-Associated Infection
HCFAC - Health Care Fraud and Abuse Control
HCPCS – Healthcare Common Procedure Coding System
HCPLAN – Health Care Payment Learning and Action Network
HEDIS - Healthcare Effectiveness Data and Information Set
HHS – Health and Human Services, US Department of
HIE – Health Information Exchange
HIPAA – Health Insurance Portability and Accountability Act of 1996
HIT – Health Information Technology
HITECH – Health Information Technology for Economic and Clinical Health Act
HPHS – High-performing health system
HPSA - Health Professional Shortage Area
HHS - Department of Health & Human Services
HOPD – Hospital Outpatient Department
HRSA - Health Resources and Services Administration
ICD-10-CM – International classification of diseases, 10th revision, Clinical Modification
ICU – Intensive care unit
IDS – Integrated delivery system
IMPACT – Improving Medicare Post-Acute Care Transformation Act of 2014
IOASE – In-office ancillary services exception
IOM – Institute of Medicine
IPAB – Independent Payment Advisory Board
IPPS – Medicare Hospital Inpatient Prospective Payment System
IT - Information technology
LTC – Long-term care
LTCH – Long-term care hospital
LTSS – Long term social services
MA – Medicare Advantage
MAC – Medicare Administrative Contractor
MACPAC – Medicaid and CHIP Payment and Access Commission
MACRA – Medicare Access and CHIP Reauthorization Act of 2015
MCO – Managed care organization
MDH-Medicare Dependent Hospitals
MDP – Measure Development Plan
MedPAC – Medicare Payment Advisory Commission
MHI – Mental Health Integration
MIPPA – Medicare Improvements for Patients and Providers Act of 2008
MIPS – Merit-based Incentive Payment System
MLR - Minimum Loss Rate
MMA – “Medicare Modernization Act” or the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003
MPFS – Medicare Physician Fee Schedule
MSMG – Multi-specialty medical group
MSPB - Medicare Spending per Beneficiary
MSSP – Medicare Shared Savings Program, also known as the ACO program
MTM – Medication Therapy Management
MU – Meaningful Use of Certified EHR Technology
MUA - Medically Underserved Area
NCQA – National Committee for Quality Assessment
NIH – National Institutes of Health
NPI - National Provider Identifier
NPRM – Notice of Proposed Rule Making
NQF – National Quality Forum
NQS – National Quality Strategy
OCM – Oncology Care Model
OCR – Office for Civil Rights
OIG – Office of the Inspector General
OMB – Office of Management and Budget
ONC – Office of the National Coordinator for Health Information Technology
OPPS – Medicare Hospital Outpatient Prospective Payment System
PCMH – Patient-Centered Medical Home
PCORI – Patient-Centered Outcomes Research Institute
PECOS – Medicare Provider Enrollment, Chain and Ownership System
P4P – Pay for Performance
PFPMs - Physician Focused Payment Models
PFS – Medicare Physician Fee Schedule
PHS - Public Health Service
PMPM – per-member/per-month
PPACA – Patient Protection and Affordable Care Act
PQRS – Physician Quality Reporting System (CMS)
PTAC – Professional and Technical Advisory Committee
QA – Quality assurance
QCDR – Qualified Clinical Data Registry
QE – Qualified Entity
QI – quality improvement
QIO – Quality Improvement Organization
QP - Qualifying APM Professional
QRDA – Quality Reporting Document Architecture
QRUR – Quality and Resource Use Reports
RAC – Recovery Audit Contractor
RBRVS – Resource-Based Relative Value Scale
RUC – AMA/Specialty Society Relative Value Update Committee
RVU – Relative value unit
SAMHSA – Substance Abuse and Mental Health Services Administration
SCHIP – State Children's Health Insurance Program (see CHIP)
SGR – Sustainable Growth Rate
SNF – Skilled Nursing Facility
SNP – Special Needs Plan
SSA – Social Security Administration
TCPI - Transforming Clinical Practice Initiative
TIN - Tax Identification Number
TMA – Transitional Medical Assistance
VBP – Hospital Value-Based Purchasing
VM– Value-Based Payment Modifier