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AABB is an international, not-for-profit organization representing individuals and institutions involved in the field of transfusion medicine and biotherapies.
Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health services ("DHS") if the physician has a financial relationship with that entity.
The Joint Commission is a United States-based nonprofit tax-exempt 501(c) organization that accredits more than 22,000 US health care organizations and programs. The international branch accredits medical services from around the world.
QS/1 is an American software company which develops management software for pharmacies. It was founded in 1944 and is based in Spartanburg, South Carolina.
In the healthcare industry, pay for performance (P4P), also known as "value-based purchasing", is a payment model that offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures. Clinical outcomes, such as longer survival, are difficult to measure, so pay for performance systems usually evaluate process quality and efficiency, such as measuring blood pressure, lowering blood pressure, or counseling patients to stop smoking. This model also penalizes health care providers for poor outcomes, medical errors, or increased costs. Integrated delivery systems where insurers and providers share in the cost are intended to help align incentives for value-based care.
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers, including commercial healthcare insurers. The transition to the NPI was mandated as part of the Administrative Simplifications portion of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
This article discusses the definitions and types of home medical equipment (HME), also known as durable medical equipment (DME), and durable medical equipment and prosthetics and orthotics (DMEPOS).
Hospital accreditation has been defined as “A self-assessment and external peer assessment process used by health care organizations to accurately assess their level of performance in relation to established standards and to implement ways to continuously improve”. Critically, accreditation is not just about standard-setting: there are analytical, counseling and self-improvement dimensions to the process. There are parallel issues in evidence-based medicine, quality assurance and medical ethics, and the reduction of medical error is a key role of the accreditation process. Hospital accreditation is therefore one component in the maintenance of patient safety. However, there is limited and contested evidence supporting the effectiveness of accreditation programs.
The Accreditation Commission for Health Care (ACHC) is a United States non-profit health care accrediting organization. It represents an alternative to the Joint Commission and CHAP, The Community Health Accreditation Program.
The Accreditation Association for Ambulatory Health Care (AAAHC), founded in 1979, is an American organization which accredits ambulatory health care organizations, including ambulatory surgery centers, office-based surgery centers, endoscopy centers, and college student health centers, as well as health plans, such as health maintenance organizations and preferred provider organizations. AAAHC has been granted "deemed status" to certify ambulatory surgery centers for Medicare by the Centers for Medicare and Medicaid Services. In 2009, the AAAHC added the Medical home to the types of organizations that it accredits. It offers on-site surveys for organizations seeking Medical Home accreditation or certification.
The Healthcare Facilities Accreditation Program (HFAP) is a not-for-profit organization meant to help healthcare organizations maintain their standards in patient care and comply with regulations and the healthcare environment. Headquartered in Chicago, HFAP is an accreditation organization with authority from Centers for Medicare and Medicaid Services.
Bundled payment is the reimbursement of health care providers "on the basis of expected costs for clinically-defined episodes of care." It has been described as "a middle ground" between fee-for-service reimbursement and capitation, given that risk is shared between payer and provider. Bundled payments have been proposed in the health care reform debate in the United States as a strategy for reducing health care costs, especially during the Obama administration (2009–2016). Commercial payers have shown interest in bundled payments in order to reduce costs. In 2012, it was estimated that approximately one-third of the United States healthcare reimbursement used bundled methodology.
Walton Rehabilitation Hospital is a non-profit rehabilitation center located in Augusta, Georgia, United States which has won numerous awards for the quality of its healthcare. The hospital was founded in 1988 and is one component of the Walton Rehabilitation Health System. This hospital offers both inpatient and outpatient programs to teens and adults and assesses disabling illnesses, stroke, head injuries, spinal injuries, and orthopedic injuries. Walton is the only specialized provider of rehabilitation in the Central Savannah River Area of Georgia. Its published mission is to "enhance the quality of life for people with acquired disabilities."
An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation. The organization is accountable to patients and third-party payers for the quality, appropriateness and efficiency of the health care provided. According to the Centers for Medicare and Medicaid Services, an ACO is "an organization of health care practitioners that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it".
Carenet Health is an American provider of healthcare services. The company provides support services, healthcare navigation services, care management programs and consumer engagement solutions to private and public institutions. Their clients include healthcare companies, hospital systems, employer groups, the US Military, and government-sponsored programs such as Medicare and Medicaid.
Credentialing is the process of establishing the qualifications of licensed medical professionals and assessing their background and legitimacy.
Health care analytics is the health care analysis activities that can be undertaken as a result of data collected from four areas within healthcare; claims and cost data, pharmaceutical and research and development (R&D) data, clinical data, and patient behavior and sentiment data (patient behaviors and preferences,. Health care analytics is a growing industry in the United States, expected to grow to more than $31 billion by 2022. The industry focuses on the areas of clinical analysis, financial analysis, supply chain analysis, as well as marketing, fraud and HR analysis.
Deemed status is a hospital accreditation for hospitals in the United States.
References
- 1 2 "Focus On: The Compliance Team emphasizes exemplary service". Drug Store News. Retrieved 2024-05-30.
- ↑ "Healthcare Compliance Strategies" (PDF). competingbid.com. Archived from the original (PDF) on 2008-06-25.
- ↑ Watanabe, Laurie (2024-03-29). "The Compliance Team Celebrates 30th Anniversary". HME Business. Retrieved 2024-04-23.
- ↑ Roy, Sree (2014-03-20). "The Compliance Team Celebrates 20 Years". Sleep Review. Retrieved 2024-04-23.
- ↑ "The Compliance Team Announces New Clinical Disease Management Program". Rural Spotlight. 2022-05-13. Retrieved 2024-05-30.
- 1 2 Watanabe, Laurie (2023-04-20). "The Compliance Team Debuts Accreditation Program for Local Health Departments". HME Business. Retrieved 2024-04-25.
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