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