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Glossary of Terms 2010 Affordable Care Act: The Patient Protection and Affordable Care Act (PPACA) informally referred to as Obamacare is a United States federal statute signed into law by President Barack Obama on March 23, 2010 after nearly a year of overall consideration by both chambers of Congress. It provides for a movement towards universal coverage, as well as providing for measures that are intended to curtail health care costs. Acute Care: Short-term medical treatment, usually in a hospital, for patients having an acute illness or injury or recovering from surgery. Acute illness: Any illness characterized by signs and symptoms of rapid onset and short duration Acute myocardial function: An acute myocardial infarction (AMI), also called a heart attack, happens when one of the heart’s arteries becomes blocked and the supply of blood and oxygen to part of the heart muscle is slowed or stopped. When the heart muscle doesn't get the oxygen and nutrients it needs, the affected heart tissue may die. Care Transition: The term "care transitions" refers to the movement patients make between health care practitioners and settings as their condition and care needs change during the course of a chronic or acute illness. For example, in the course of an acute exacerbation of an illness, a patient might receive care from a PCP or specialist in an outpatient setting, then transition to a hospital physician and nursing team during an inpatient admission before moving on to yet another care team at a skilled nursing facility. Finally, the patient might return home, where he or she would receive care from a visiting nurse. Each of these shifts from care providers and settings is defined as a care transition. Chronic illness: Chronic is the opposite of acute - meaning a long term condition, for example chronic bronchitis. Chronic may also be confused by the general public to mean severe. Once again, this is a different definition medically and something can be chronic but not severe. HospitalistCMS Center for Medicare and Medicaid Services. The federal agency that runs the Medicare program for the elderly aged and disabled. In addition, CMS works with the states to run the Medicaid program for low-income individuals. CMS works to make sure that the people in these programs are able to get high quality health care. Hospitalist: The term hospitalist was coined in 1996 and is applied to a medical practitioner whose primary focus is care of patients in the hospital setting. In most situations, hospitalists do not have an office practice. Although there is some variability, most hospitalists are trained in general internal medicine, meaning they are trained to diagnose and treat disease in adults. Hospital Outcomes: Outcomes of care and patient experiences of hospital stays are publicly reported on the medicare.gov site, allowing consumers and health care providers compare performances of hospitals within their geographic area. Med Pac: The Medicare Payment Advisory Commission (MedPAC) is an independent Congressional agency established by the Balanced Budget Act of 1997 (P.L. 105-33) to advise the U.S. Congress on issues affecting the Medicare program. The Commission's statutory mandate is quite broad: In addition to advising the Congress on payments to private health plans participating in Medicare and providers in Medicare's traditional fee-for-service program, MedPAC is also tasked with analyzing access to care, quality of care, and other issues affecting Medicare Post Acute Care (PAC): The type of care provided after a hospitalization. It can include intense nursing and rehabilitation for individuals who have been hospitalized and require further nursing care and rehabilitation services. Post Acute care can occur in nursing, rehabilitation facilities and home health facilities. Sometimes referred to as sub-acute care. PCP: Primary Care Physician is a physician/medical doctor who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis. Prospective Pay: Hospitals that have contracted with Medicare to provide acute inpatient care and accept a predetermined rate as payment in full. Readmission: Readmission occurs when a patient is discharged from the applicable hospital to a non acute setting and then is readmitted to the same or another acute care within 30 days for any reason Risk adjustment The statistical process of accounting for differences in patients’ sickness before they were admitted to the hospital is called risk adjustment. This statistical process aims to ‘level the playing field’ by accounting for health risks that patients have before they enter the hospital. Utilization Review: Hospital utilization review plans are the documentation that determine how long a patient stays in a hospital for treatment or even if the patient is admitted to a hospital for treatment. It a process aimed at providing quality patient care in a cost-effective manner, reducing hospital admissions and lengths of stay in medical facilities. It compares proposed treatment options to national averages and standards, and is used to determine whether private insurance companies or government-backed Medicaid covers hospital lengths of stay Value Based Reimbursement: Requires bundled payment of services over a cycle of care. In its simplest form, healthcare providers are incentivized for “good outcomes” and penalized for “bad outcomes”.