The specific line item in the state budget that represents the Medicaid budget under the Ohio Department of Job and Family Services.
Contact:
anesthesiologist assistant
Contact:
American Accreditation Healthcare Commission, formerly Utilization Review Accreditation Commission
Contact:
American Association of Health Plans
Contact:
Association of American Medical Colleges
Contact:
average adjusted per capita cost
Contact:
American Association of Respiratory Care
Contact:
American College of Cardiology
Contact:
A patient's ability to obtain medical care. The ease of access is determined by components such as the availablitiy of medical services and their acceptability to the patient, availablitiy of insurance, the location of health care facilities, transportation, hours of operation, affordability and cost of care.
Contact: Berna Bell
Approval by an authorizing agency for institutions and programs that meet or exceed a set of predetermined standards.
Contact: Rosalie Weakland, RN, MSN
American College of Healthcare Executives
Contact:
American College of Surgeons
Contact:
|
activities of daily living
(ADLs)
|
Activities performed as part of a person's daily routine of self-care such as bathing, dressing, toileting and eating.
Contact:
Hospital care given to patients who generally require a stay of several days that focuses on a physical or mental condition requiring immediate intervention and constant medical attention, equipment and personnel.
Contact:
Americans with Disabilities Act
Contact:
Aid to Families with Dependent Children
Contact:
activities of daily living
Contact:
Costs related to activities such as utilization review, marketing, medical underwriting, commissions, premium collection, claims processing, insurer profit, quality assurance and risk management for purposes of insurance.
Contact:
associate degree in nursing
Contact:
A document that patients complete to direct their medical care when they are unable to communicate their own wishes due to a medical condition. In Ohio, do not resuscitate orders, living wills and durable powers of attorney are advance directives that are authorized by state law. (see do not resuscitate, durable power of attorney and living will)
Contact: Rick Sites, Esq.
|
advanced practice nurse
(APN)
|
A registered nurse who is approved by the Board of Nursing to practice nursing in a specified area of advanced nursing practice. APN is an umbrella term given to a registered nurse who has met advanced educational and clinical practice requirements beyond the two to four years of basic nursing education required of all RNs. There are four types: 1) certified registered nurse anesthetist (CRNA); 2) clinical nurse specialist (CNS); 3) certified nurse practitioner (CNP); and 4) certified nurse midwife (CNM).
Contact: Rosalie Weakland, RN, MSN
Any incident in which the use of medication (drug or biologic) at any dose, a medical device, or a special nutritional product may have resulted in an adverse outcome in a patient.
Contact:
An injury resulting from a medical intervention that is not due to the underlying condition of the patient.
Contact:
Among applicants for a given group or individual health insurance program, the tendency for those with an impaired health status, or those who are prone to higher-than-average utilization of benefits, to be enrolled in disproportionate numbers in lower deductible plans.
Contact: Mary L. Gallagher, Esq.
Services following hospitalization or rehabilitation, individualized for each patient's needs. Aftercare gradually phases the patient out of treatment while providing follow-up attention to prevent relapse.
Contact:
attorney general
Contact:
|
Agency for Healthcare Research and Quality
(AHRQ)
|
A federal agency within the Public Health Service responsible for research on quality, appropriateness and cost of health care. AHRQ also centralizes access to state inpatient data. www.ahrq.gov
Contact: David Engler, PhD
American Heart Association or American Hospital Association
Contact:
American Health Care Association
Contact:
Agency for Health Care Policy and Research
Contact:
Agency for Health Research and Quality
Contact:
acquired immunodeficiency syndrome
Contact:
|
Akron Regional Hospital Association
(ARHA)
|
A regional allied association representing hospitals and health systems in the Akron, Ohio, region. www.arha.org
Contact:
Specially trained and often licensed health workers other than physicians, dentists, optometrists, chiropractors, podiatrists and nurses. The term is sometimes used synonymously with paramedical personnel, which are all health workers who perform tasks that must otherwise be performed by a physician, or health workers who do not usually engage in independent practice.
Contact:
One of two schools of medicine that treat disease by inducing effects opposite to those produced by the disease. The other school of medicine is osteopathic.
Contact:
Charges for services rendered or supplies furnished by a health provider that qualify as covered expenses for insurance purposes.
Contact:
average length of stay
Contact:
An alternative to traditional inpatient care system such as ambulatory care, home health care and same-day surgery.
Contact:
Treatment procedures that are not supported by mainstream medicine, often due to lack of supporting experimental data.
Contact:
Amended. A designation sometimes found before a House or Senate bill number showing that formal changes have been made to an introduced piece of legislation during the legislative process.
Contact:
American Medical Association
Contact:
The practice of a hospital replenishing certain drugs and supplies used by an ambulance service during transport of a patient to the hospital.
Contact:
Care given to patients who do not require overnight hospitalization.
Contact:
|
ambulatory patient group
(APG)
|
The Medicare program's prospective payment system for outpatient services and procedures. Each APG is a classified medical service or procedure. Unlike diagnosis related group reimbursement for inpatient care, where medical events are condensed into one diagnostic related group, an outpatient visit can combine several different APGs.
Contact: Charles Cataline
|
ambulatory payment classification
(APC)
|
Groups or groupings of medical procedures and services used as a basis for reimbursement under the Medicare outpatient prospective payment system.
Contact: Charles Cataline
An institutional health setting in which organized health services are provided on an outpatient basis, such as a surgery center, clinic or other outpatient facility. Ambulatory care settings also may be mobile units of service (e.g., mobile mammography, MRI).
Contact:
|
ambulatory surgical facility
|
see freestanding outpatient surgical center
Contact:
|
American Accreditation Healthcare Commission
(AAHC)
|
|
American College of Healthcare Executives
(ACHE)
|
An international professional society of nearly 30,000 health care executives based in Chicago. www.ache.org
Contact:
|
American Health Care Association
(AHCA)
|
A trade association representing nursing homes and long-term care facilities in the U.S. based in Washington, D.C. www.ahca.org
Contact:
|
American Hospital Association
(AHA)
|
|
American Medical Association
(AMA)
|
A national association organized into local and regional societies that represents over 700,000 medical doctors in the United States. AMA is based in Chicago. www.ama-assn.org
Contact:
|
American Osteopathic Association
(AOA)
|
A national association organized into local and regional societies that represents over 43,000 osteopathic physicians in the United States. AOA is based in Chicago and also provides accreditation for hospitals and colleges of osteopathic medicine. www.osteopathic.org
Contact:
|
American Society For Clinical Laboratory Science
(ASCLS)
|
An organization for clinical laboratory science practitioners, providing leadership and promoting all aspects of clinical laboratory science practice, education and management to ensure cost-effective laboratory services for health care consumers. www.ascls.org
Contact:
|
Americans With Disabilies Act
(ADA)
|
acute myocardial infarction (heart attack)
Contact:
A term used to describe additional services performed related to care, such as lab work, X-ray and anesthesia.
Contact:
|
Annual Hospital Registration and Planning Report
|
An annual report of health care statistics that hospitals are required by law to file with the Ohio Department of Health.
Contact:
A federal law that prohibits the paying or receiving of remuneration in exchange for the referral of patients or business paid by a federal health care program.
Contact: Mary L. Gallagher, Esq.
A situation in which a single entity, such as an integrated delivery system, controls enough of the practices in any one specialty in a relevant market to have monopoly power (e.g., the power to increase prices).
Contact: Mary L. Gallagher, Esq.
A term used to describe legislation requiring a health plan to accept on its provider panels every physician, hospital or other practitioner that wants to participate in the health plan’s products.
Contact:
American Osteopathic Association
Contact:
American Organization of Nurse Executives
Contact:
Association of Ohio Philanthropic Homes, Housing and Services for the Aging
Contact:
ambulatory payment classification
Contact:
ambulatory patient group
Contact:
advanced practice nurse
Contact:
|
approved health care facility or program
|
A facility or program that is licensed, certified or otherwise authorized pursuant to the laws of the state to provide health care and that is approved by a health plan to provide the care described in a contract.
Contact:
Akron Regional Hospital Association
Contact:
American Society of Association Executives
Contact:
ambulatory surgical center
Contact:
Office of the Assistant Secretary for Preparedness and Response
Contact:
|
associate degree in nursing
(ADA)
|
A degree received after completing a two-year nursing education program at a college or university that qualifies a nurse to take a national licensing exam (NCLEX) to become a registered nurse.
Contact:
Chief law enforcement officer of a state, responsible for advising the state or nation of legal matters.
Contact: Mary L. Gallagher, Esq.
|
average adjusted per capita cost
(AAPCC)
|
Payment rates used by the Centers for Medicare & Medicaid Services to reimburse managed care organizations for care delivered to Medicare enrollees.
Contact:
|
average length of stay
(ALOS)
|
A standard hospital statistic used to determine the average amount of time between admission and departure for patients in a diagnosis related group, an age group, a specific hospital or other factors.
Contact:
Caused by influenza viruses that occur naturally among wild birds. The H5N1 variant is deadly to domestic fowl and can be transmitted from birds to humans. There is no human immunity and no vaccine is available. (see also seasonal flu and pandemic flu)
Contact: Carol Jacobson
|
bachelor of science in nursing
(BSN)
|
A degree received after completing a four-year college or university program that qualifies a graduate nurse to take a national licensing exam (NCLEX) to become a registered nurse.
Contact: Rosalie Weakland, RN, MSN
Results when patients do not pay bills for which payment was expected. It occurs for a variety of reasons, such as when uninsured patients have incomes above the guidelines for charity care, but still cannot afford the cost of their care.
Contact: Charles Cataline
A provider's billing of a covered person directly for charges above the amount reimbursed by the health plan. This may or may not be allowed, depending upon the contractual arrangements between the parties.
Contact:
|
Balanced Budget Act of 1997
(BBA)
|
A federal law enacted by U.S. Congress that makes numerous changes to various titles of the Social Security Act, contains significant changes to the Medicare and Medicaid programs, and creates a new Title XXI, the State Children's Health Insurance Program (SCHIP). Payment reductions and other changes enacted under the BBA likely will continue to be the focus of advocacy efforts for hospitals and other providers throughout the early 21st century.
Contact:
|
Balanced Budget Refinement Act of 1999
(BBRA)
|
A federal law enacted by U.S. Congress that restores an estimated $17 billion to the Medicare program. The law provides relief for hospitals, and includes special packages for rural and teaching hospitals, nursing homes and home health agencies.
Contact:
Balanced Budget Act of 1997
Contact:
Balanced Budget Refinement Act of 1999
Contact:
Blue Cross and Blue Shield Association
Contact:
Mental health services, including services for alcohol and substance abuse.
Contact: Berna Bell
A person designated by an insuring organization as eligible to receive insurance benefits.
Contact:
|
Benefits Improvement and Protection Act of 2000
(BIPA)
|
A federal law enacted by U.S. Congress that, among other provisions, restores an estimated $11.5 billion over five years to hospitals under Medicare, Medicaid and other federal and state health care programs.
Contact:
|
bioterrorism planning regions
|
Ohio is divided into seven regions to promote regional bioterrorism planning between hospitals, public health and all responding agencies to a terrorist event.
Contact: Rick Sites, Esq., Carol Jacobson
Benefits Improvement and Protection Act of 2000
Contact:
|
Blue Cross and Blue Shield Association
(BC/BS)
|
An organization that offers information, consultation, representation and operational services for the Blue Cross and Blue Shield plan members across the country for purposes of providing insurance benefits. www.bluecares.com
Contact:
A clinician who has passed the national examination in a particular field. Board certification is available for most physician specialties, as well as for many allied medical professions.
Contact:
bachelor of science in nursing
Contact:
|
Bureau of Workers' Compensation
(BWC)
|
The state-operated insurance system that pays medical and lost wage benefits to workers who are injured on the job. www.ohiobwc.com
Contact: Charles Cataline
Bureau of Workers' Compensation
Contact:
coronary artery bypass graft
Contact:
critical access hospital
Contact:
chief administrative officer
Contact:
capitation or OHA Committee on Advocacy and Policy
Contact:
A stipulated dollar amount established to cover the cost of health care delivered for a person or group of persons. The term usually refers to a negotiated per capita rate to be paid periodically, usually monthly, to a health care provider. The provider is responsible for delivering or arranging for the delivery of all health services required by the covered person(s) under the conditions of the contract.
Contact:
A wholly owned subsidiary of a business or other legal entity, including a group of hospitals or trade associations, that is formed to insure risk. A captive is a form of self-insurance that has assumed the formalities of an insurance company.
Contact:
core analysis research evolution
Contact:
The Core Analysis Research Evolution (CARE) System is a set of process measures used for quality improvement. The system meets Joint Commission and CMS core measurement requirements.
Contact: Virginia Swan, Rosalie Weakland, RN, MSN
An online education service of more than 40 state hospital associations along with the American Hospital Association (AHA) for the purpose of delivering more cost-effective education to hospitals. www.carelearning.com
Contact: David Grunwell
The Medicare Part B claims processing contractor.
Contact:
A health care professional who monitors the allocation and coordination of a patient's overall care.
Contact:
A measure of relative severity of medical conditions of a hospital's patients.
Contact:
computerized axial tomography
Contact:
U.S. Congressional Budget Office
Contact:
Community Centers for the Deaf
Contact:
Correct Coding Initiative (CMS)
Contact:
coronary care unit
Contact:
Centers for Disease Control and Prevention
Contact:
continuing education
Contact:
|
Center for Health Affairs
(CHA)
|
A regional allied association representing hospitals and health systems in Northeast Ohio. www.chanet.org
Contact:
|
Centers for Disease Control and Prevention
(CDC)
|
An agency within the U.S. Department of Health and Human Services that serves as the central point for consolidation of disease control data, health promotion and public health programs. www.cdc.gov
Contact:
|
Centers for Medicare & Medicaid Services
(CMS)
|
An agency within the U.S. Department of Health and Human Services responsible for the administration of the Medicare and Medicaid programs. Formerly called the Health Care Financing Administration. www.cms.gov
Contact: Charles Cataline
|
Central Ohio Hospital Council
(COHC)
|
chief executive officer
Contact:
|
certificate of need
(CON)
|
A designation that hospitals had to obtain from the Ohio Department of Health to authorize an activity such as constructing or modifying hospitals, purchasing certain medical equipment or providing new health care services. This process was gradually phased out for most acute care hospital activities from 1995 through 1998 and replaced with quality standards.
Contact: Rick Sites, Esq., Bridget Gargan
chief financial officer
Contact:
Code of Federal Regulations
Contact:
Center for Health Affairs
Contact:
Civilian Health and Medical Program of the Uniformed Services
Contact:
Community Health Accreditation Program
Contact:
Health care provided at a substantial discount to those unable to pay. Hospitals either do not attempt to collect a portion of charges or agree to write off charges. Eligibility is sometimes determined from a sliding scale based on a percentage of the patient's income above the federal poverty level.
Contact: Charles Cataline
|
Children's Health Insurance Program
(CHIP)
|
A state-administered program funded partly by the federal government that allows states to expand health coverage to uninsured, low-income children not eligible for Medicaid. Also called State Children’s Health Insurance Program (SCHIP). http://www.cms.hhs.gov/home/chip.asp
Contact:
Community Health Information Network
Contact:
Children's Health Insurance Program
Contact:
Children's Health Insurance Project on Hospice/Palliative Care Services
Contact:
certified hospice and palliative care nurse
Contact:
Community Health Plans of Ohio
Contact:
|
Civilian Health and Medical Program of the Uniformed Services
(CHAMPUS)
|
A program that provides funds to pay for the treatment in private institutions for members of the uniformed services and their families. (see Tricare)
Contact: Charles Cataline
|
claims-made insurance policy
|
A liability insurance policy under which coverage applies to claims filed during the policy period. Medical professional liability insurance is typically written on a claims-made basis.
Contact: Rick Sites, Esq.
Clinical Laboratory Improvement Amendments
Contact:
|
Clinical Laboratory Improvement Amendments
(CLIA)
|
Federal law designed to set national quality standards for laboratory testing. The law covers all laboratories that engage in testing for assessment, diagnosis, prevention or treatment purposes.
Contact: Rosalie Weakland, RN, MSN
|
clinical nurse specialist
(CNS)
|
A registered nurse with a graduate degree in nursing who may provide and manage the care of individuals and groups with complex health problems and provide health care services that promote, improve and manage health care within the nurse’s nursing specialty.
Contact: Rosalie Weakland, RN, MSN
Medical services delivered in the health insuring corporation (HIC)-owned health center or satellite clinic by physicians who belong to a specially formed, but legally separate, medical group that only serves the HIC.
Contact:
|
Clostridium Difficile
(C.diff)
|
Clostridium difficile
[klo-STRID-ee-um dif-uh-SEEL] is a bacterium that causes diarrhea and more serious intestinal conditions such as colitis.
Contact: Carol Jacobson
continuing medical education
Contact:
Centers for Medicare & Medicaid Services (formerly HCFA)
Contact:
California Nurses Association
Contact:
continuing nursing education
Contact:
certified nurse-midwife
Contact:
certified nurse practitioner
Contact:
clinical nurse specialist
Contact:
A specified dollar amount or percentage of covered expenses that an insurance policy or Medicare requires a beneficiary to pay toward eligible medical bills.
Contact:
Consolidated Omnibus Budget Reconciliation Act
Contact:
|
Code of Federal Regulations
(CFR)
|
Central Ohio Hospital Council
Contact:
Hospital community benefit includes programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. A community benefit must meet at least one of the following criteria: generates a low or negative margin, responds to needs of special populations, supplies services that would likely be discontinued if considered on a purely financial basis, responds to public health needs, and/or involves education or research that improves overall community health. www.caringforcommunities.org/caringforcommunities/
Contact: Mary Yost
|
Community Health Information Network
(CHIN)
|
A community-based activity that focuses on the development of a shared information database and retrieval system of patients, their medical histories and clinical and diagnostic tests.
Contact:
Setting insurance rates based on the average cost of providing health services to all people in a geographic area without adjusting for each individual’s medical history or likelihood of using medical services.
Contact:
|
Computerized Physician Order Entry
(CPOE)
|
A system that allows physicians to write medical orders for their hospitalized patients using a clinical software application.
Contact:
certificate of need
Contact:
A bi-partisan committee made up of three members from each chamber of the Ohio General Assembly or U.S. Congress that is responsible for working out differences between House- and Senate-passed versions of a piece of legislation.
Contact:
|
Congressional Budget Office
|
A non-partisan office that provides U.S. Congress with cost estimates of legislative proposals and calculates estimates related to the federal budget.
Contact: Jonathan Archey, NREMT-B
|
Consolidated Omnibus Budget Reconciliation Act
(COBRA)
|
Health benefit provisions passed by Congress in 1986 amending the Employee Retirement Income Security Act, the Internal Revenue Code and the Public Health Service Act to provide continuation of group health coverage that otherwise might be terminated.
see Omnibus Budget Reconciliation Act
Contact:
|
continuing education unit
(CEU)
|
A uniform unit of measurement used to assess all levels of noncredit continuing education. One CEU is equivalent to 10 contact hours of participation in an organized continuing education experience.
Contact: Joseph Ruggles
|
continuing medical education
(CME)
|
The continuing education of practicing physicians and nurses through refresher courses, journals and texts, educational programs and self-study courses. In some states, including Ohio, continuing education is required for continued licensure.
Contact:
|
Continuous Service Readiness Program
(CSR)
|
A joint effort of OHA and the Joint Commission Resources, the Continuous Service Readiness® program helps hospitals attain a level of continuous survey readiness for accreditation surveys.
Contact: Dorothy Aldridge, Rosalie Weakland, RN, MSN
A seven-member board consisting of six legislators and one appointee of the Ohio Office of Budget and Management that, under certain conditions, has authority to increase spending levels and authorize expenditures for state agencies and programs
Contact:
chief operating officer
Contact:
Provisions and procedures used by third-party payers to determine the amount payable when a claimant is covered under two or more health plans.
Contact:
A type of cost-sharing that requires the insured or subscriber to pay a specified flat dollar amount, usually on a per-unit-of-service basis, with the third-party payer reimbursing some portion of the remaining charges.
Contact:
chronic obstructive pulmonary disease
Contact:
A strategy whereby a labor union aggressively attacks the public reputation of a target employer with a goal of forcing management to yield to the union's demands or risk the company's financial well-being.
Contact:
An organization doing business with Ohio hospitals that is a member in good standing with OHA.
Contact: Joseph Ruggles
|
corporate practice of medicine
|
A state law doctrine that prohibits any person or entity other than a licensed physician from holding itself out as a provider of professional medical services, from billing in its name for such professional medical services, or from owning or controlling a professional medical delivery system.
Contact: Mary L. Gallagher, Esq.
The price a hospital must pay to provide a service, including the price of providing facilities, technology and workforce.
Contact:
Commission on Professional and Hospital Activities
Contact:
consumer price index
Contact:
The process of reviewing a practitioner’s academic, clinical and professional ability as demonstrated in the past to determine if criteria for clinical privileges are met.
Contact:
|
critical access hospital
(CAH)
|
A federal designation under which hospitals receive cost- based reimbursement for Medicare services. Hospitals must meet certain criteria, such as size, length of stay and proximity to other facilities.
Contact: Rick Sites, Esq.
Standardized specifications for care developed by a formal process that incorporates the best scientific evidence of effectiveness with expert opinion.
Contact:
certified registered nurse anesthetist
Contact:
Continuous Service Readiness Program
Contact:
disability assistance
Contact:
An amount which a policyholder agrees to pay, per claim or per accident, toward the total amount of an insured loss. Under a health insurance policy, the out-of-pocket expenses paid by the health insurance subscriber before the insurer will begin reimbursing the subscriber for additional medical expenses.
Contact:
|
diagnostic related group
(DRG)
|
A classification system that groups patients by common characteristics requiring treatment.
Contact: Charles Cataline
|
Disability Medical Assistance
|
A state administered program that provides limited medical assistance to persons who are medication-dependent and ineligible for any category of Medicaid. There is no federal funding or federal regulation of this program.
Contact:
see Ohio Emergency Codes
Contact:
The evaluation of patients' health needs for appropriate care after discharge from an inpatient setting.
Contact: Dan Paoletti
|
disproportionate share hospital
(DSH)
|
A hospital that provides care to a high number of patients who cannot afford to pay and/or do not have insurance.
Contact:
The routing of patients to other hospitals because an emergency room is at maximum capacity.
Contact:
durable medical equipment
Contact:
do not resuscitate
Contact:
doctor of osteopathy
Contact:
An advance directive that patients may make to forego cardiopulmonary resuscitation or other resuscitative efforts. (see advance directive)
Contact: Rick Sites, Esq.
|
doctor of osteopathy
(DO)
|
A licensed physician who is a graduate from an accredited school of osteopathic medicine.
Contact:
Department of Justice
Contact:
diagnostic related group
Contact:
disproportionate share hospital
Contact:
|
durable medical equipment
(DME)
|
Equipment that can stand repeated use, is primarily and customarily used to serve a medical purpose, generally is not useful to a person in the absence of illness or injury, and is appropriate for use at home, such as hospital beds, wheelchairs and oxygen equipment.
Contact:
|
durable power of attorney
|
A document in which individuals select another person to act on their behalf in the event they become incapacitated. The document may identify specific activities, such as managing the incapacitated person's financial affairs. If the document allows the agent to make health care decisions, it must be drafted in a manner that meets statutory requirements for a "health care durable power of attorney." (see advance directive)
Contact: Rick Sites, Esq.
essential access community hospital
Contact:
emergency department
Contact:
electronic data interchange
Contact:
electrocardiogram
Contact:
|
electronic health record
(EHR)
|
A patient’s computerized health information as recorded and maintained by a provider system. An EHR is distinguished from a physician health record (PHR) by control: an EHR is controlled by the provider’s system while a PHR is owned and controlled by the patient.
Contact: Dan Paoletti
|
emergency medical services
(EMS)
|
A system of health care professionals, facilities and equipment providing emergency care.
Contact:
|
emergency medical technician
(EMT)
|
A person certified to provide pre-hospital emergency medical treatment.
Contact:
|
Employee Retirement Income Security Act
(ERISA)
|
A federal law that exempts self-insured health plans from state laws governing health insurance, including contribution to risk pools, prohibitions against disease discrimination and other state health reforms.
Contact:
emergency medical services
Contact:
emergency medical technician
Contact:
Emergency Medical Treatment and Active Labor Act
Contact:
|
Environmental Protection Agency
(EPA)
|
A federal and state agency responsible for programs to control air, water and noise pollution, solid waste disposal and other environmental concerns. www.epa.gov
Contact: Rick Sites, Esq.
Environmental Protection Agency
Contact:
Employee Retirement Income Security Act
Contact:
Specific conditions or circumstances listed in an insurance contract for which the policy will not provide benefit payments. Exclusions can eliminate coverage for select individuals, groups, locations, properties or risks.
Contact:
A system where an insurance company evaluates the risk of an individual or group by considering the applicant's loss history. For health insurance this would include evaluation of the applicant's health history.
Contact:
|
Extended Reporting Period
|
An additional period of time after policy expiration during which valid claims will be paid under a claims-made policy of liability insurance.
Contact:
Fellow of American College of Healthcare Executives
Contact:
Federation of American Hospitals
Contact:
|
failure mode effect analysis
|
A federal law that imposes liability for treble damages and fines of $5,000 to $10,000 for knowingly submitting to the federal government a false or fraudulent claim for payment.
Contact: Sean M. McGlone, Esq.
|
Farmers Home Administration
(FHA)
|
A division of the U.S. Department of Agriculture that guarantees hospital mortgages.
Contact:
U.S. Food and Drug Administration
Contact:
formula-driven overpayment
Contact:
|
federal financial participation
(FFP)
|
The portion paid by the federal government to states for their share of expenditures for providing Medicaid services and for administering the Medicaid program and certain other human service programs. Also called federal medical assistance percentage (FMAP).
Contact:
|
federal fiscal year
(FFY)
|
The federal government's accounting year, which begins Oct. 1 and ends Sept. 30 (e.g., FFY 2009 begins Oct. 1, 2008, and ends Sept. 30, 2009).
Contact:
|
federal medical assistance percentage
(FMAP)
|
The share of each state's Medicaid program paid by the federal government, based on the state's per capita income. By law, the FMAP cannot be lower than 50 percent nor higher than 83 percent, with the average FMAP about 57 percent. Ohio's 2000 FMAP is 62 percent. Also called federal financial participation.
Contact:
|
federal poverty guidelines
|
The official annual income level for poverty as defined by the federal government. Under the 2011 guidelines, the federal poverty level for a family of four is $22.350.
Contact:
|
Federation of American Hospitals
(FAH)
|
A trade association composed of proprietary or investor-owned hospitals. www.fah.org
Contact:
A method in which physicians and other health care providers receive a fee for services performed.
Contact:
A comprehensive listing of fees used by either a health care plan or the government to reimburse providers on a fee-for-service basis.
Contact:
|
Fellow of American College of Healthcare Executives
(FACHE)
|
A credential awarded by the American College of Healthcare Executives.
Contact:
federal financial participation
Contact:
federal fiscal year
Contact:
Farmers Home Administration
Contact:
fiscal intermediary
Contact:
see Medicare Administrative Contractor
Contact:
An analysis by the Legislative Budget Office of the financial impact of proposed state legislation
Contact:
Any entity's accounting year.
Contact:
federal medical assistance percentage
Contact:
Freedom of Information Act
Contact:
|
Food and Drug Administration
(FDA)
|
An agency within the federal government that is responsible for regulations pertaining to food and drugs sold in the United States. www.fda.gov
Contact:
|
Foundation for Healthy Communities
|
federally qualified health center
Contact:
|
freestanding emergency medical service center
|
A health care facility that is physically separate from a hospital and whose primary purpose is the provision of immediate, short-term medical care for minor but urgent medical conditions. (see urgent care)
Contact: Rick Sites, Esq.
|
freestanding outpatient surgical center
|
A health care facility, physically separate from a hospital, that provides pre-scheduled, outpatient surgical services. (see surgicenter or ambulatory surgical facility)
Contact: Rick Sites, Esq.
|
Friends of Ohio Hospitals
|
Federal Trade Commission
Contact:
full-time equivalent
Contact:
|
full-time equivalent
(FTE)
|
A standardized accounting of the numbers of full-time and part-time employees.
Contact:
An initiative created by the Ohio Organization for Nurse Executives and OHA to design the future of clinical health care in response to the current health care workforce shortage. www.futurethink.org
Contact: Rosalie Weakland, RN, MSN
general assistance
Contact:
General Accounting Office
Contact:
A primary care physician responsible for overseeing and coordinating all aspects of a patient’s medical care and pre-authorizing specialty care.
Contact:
Greater Cincinnati Health Council
Contact:
Greater Dayton Area Hospital Association
Contact:
A physician whose practice is based on a broad understanding of all illnesses and who does not restrict his/her practice to any particular field of medicine.
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graduate medical education
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The colloquial term describing the choice of an individual, provider or other legal entity not to purchase liability insurance such as medical liability insurance or have a self-insurance mechanism such as a trust fund, or captive insurance company.
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Government Accountability Office
(GAO)
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A non-partisan investigative arm of U.S. Congress that evaluates federal programs as an oversight of federal spending, efficiency and performance. www.gao.gov
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graduate medical education
(GME)
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Medical education as an intern, resident or fellow after graduating from a medical school.
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Greater Cincinnati Health Council
(GCHC)
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A regional allied association representing hospitals and health systems in the Cincinnati region. www.gchc.org
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Greater Dayton Area Hospital Association
(GDAHA)
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A regional allied association representing hospitals and health systems in the Dayton region. www.gdaha.org
Contact:
Any insurance policy or health services contract by which groups of employees (and often their dependents) are covered under a single policy or contract, issued by their employer or other group entity.
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An HMO that contracts with a multi-specialty medical group to provide care for HMO members. Members are required to receive medical care from a physician within the group unless a referral is made outside the network.
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group practice association
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A formal arrangement of three or more physicians or other health professionals providing health services. Income is pooled and redistributed to the members of the group according to a prearranged plan.
Contact:
Hospitals for a Healthy Environment
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hospital acquired infection
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Hospital Care Assurance Program
Contact:
Hospital Council of Northwest Ohio
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health care durable power of attorney
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A document in which individuals select another individual to make health care decisions for them in the event they become incapacitated. A health care durable power of attorney should be distinguished from a living will, a document drafted by an individual that provides direction regarding medical care if the individual becomes incapacitated by terminal illness or permanent unconsciousness. (see advance directive)
Contact: Rick Sites, Esq.
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health care-acquired condition
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see hospital-acquired condition
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Health Employer Data and Information Set
(HEDIS)
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A set of performance measures designed to standardize the way health plans report data to employers. HEDIS measures five major areas of health plan performance: quality, access and patient satisfaction, membership and utilization, finance, and descriptive information on health plan management.
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Health Insurance Association of America
(HIAA)
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A corporate member association of health and accident insurance companies. www.hiaa.org
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Health Insurance Portability and Accountability Act
(HIPAA)
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Federal legislation, enacted in 1996, mandating regulations governing privacy, security and administrative simplification standards for health care information. HIPAA governs how health care organizations handle all facets of information management, including patient records.
Contact: David Engler, PhD, Rick Sites, Esq.
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health insuring corporation
(HIC)
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A term for managed care insurers in Ohio which includes all Ohio HMOs and other companies that offer pre-paid managed care.
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health maintenance organization
(HMO)
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An entity that offers prepaid, comprehensive health coverage for both hospital and physician services with specific health care providers using a fixed fee structure or capitated rates.
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Health Partnership Program
(HPP)
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One of two systems for managing workers' compensation health care in Ohio. Primarily designed for state-fund employers, the HPP uses private managed-care organizations (MCOs) certified by the state Bureau of Workers’ Compensation to provide medical services.
Contact: Charles Cataline