The United States secretary of health and human services is the head of the United States Department of Health and Human Services,and serves as the principal advisor to the president of the United States on all health matters. The secretary is a member of the United States Cabinet. The office was formerly known as the secretary of health,education,and welfare. In 1980,the Department of Health,Education,and Welfare was renamed to Department of Health and Human Services,and its education functions and Rehabilitation Services Administration were transferred to the new United States Department of Education. Patricia Roberts Harris headed the department before and after it was renamed.
In the United States,Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments,which also have wide latitude in determining eligibility and benefits,but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding. States are not required to participate in the program,although all have since 1982.
Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities,including those with end stage renal disease and amyotrophic lateral sclerosis. It started in 1965 under the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services (CMS).
Diagnosis-related group (DRG) is a system to classify hospital cases into one of originally 467 groups,with the last group being "Ungroupable". This system of classification was developed as a collaborative project by Robert B Fetter,PhD,of the Yale School of Management,and John D. Thompson,MPH,of the Yale School of Public Health. The system is also referred to as "the DRGs",and its intent was to identify the "products" that a hospital provides. One example of a "product" is an appendectomy. The system was developed in anticipation of convincing Congress to use it for reimbursement,to replace "cost based" reimbursement that had been used up to that point. DRGs are assigned by a "grouper" program based on ICD diagnoses,procedures,age,sex,discharge status,and the presence of complications or comorbidities. DRGs have been used in the US since 1982 to determine how much Medicare pays the hospital for each "product",since patients within each category are clinically similar and are expected to use the same level of hospital resources. DRGs may be further grouped into Major Diagnostic Categories (MDCs). DRGs are also standard practice for establishing reimbursements for other Medicare related reimbursements such as to home healthcare providers.
The Centers for Medicare &Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid,the Children's Health Insurance Program (CHIP),and health insurance portability standards. In addition to these programs,CMS has other responsibilities,including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA),quality standards in long-term care facilities through its survey and certification process,clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments,and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001.
Medigap refers to various private health insurance plans sold to supplement Medicare in the United States. Medigap insurance provides coverage for many of the co-pays and some of the co-insurance related to Medicare-covered hospital,skilled nursing facility,home health care,ambulance,durable medical equipment,and doctor charges. Medigap's name is derived from the notion that it exists to cover the difference or "gap" between the expenses reimbursed to providers by Medicare Parts A and B for services and the total amount allowed to be charged for those services by the United States Centers for Medicare and Medicaid Services (CMS).
Thomas Andrew Scully is an American lawyer and former government official. He was the administrator of the Centers for Medicare and Medicaid Services (CMS) from 2001 to 2004 under President George W. Bush. Scully is currently a general partner at Welsh,Carson,Anderson &Stowe,a private equity investment firm,where he focuses on health care investments. Scully is also principal at Federal Health Policy Strategies and a partner at its affiliated law firm Scully,Roskey &Missmar,where he focuses on health care regulatory and legislative matters,as well as on advising clients on health policy and strategies for health care delivery.
Willingboro High School is a four-year comprehensive public high school that serves students in ninth through twelfth grades from Willingboro Township in Burlington County,in the U.S. state of New Jersey,operating as the lone secondary school of the Willingboro Public Schools.
Medicare Advantage is a type of health plan offered by private companies which was established by the Balanced Budget Act (BBA) in 1997. This created a private insurance option that wraps around traditional Medicare. Medicare Advantage plans may fill some coverage gaps and offer alternative coverage options in an attempt to make them appear more attractive to the subscriber as compared to traditional Medicare.
Healthcare reform in the United States has had a long history. Reforms have often been proposed but have rarely been accomplished. In 2010,landmark reform was passed through two federal statutes:the Patient Protection and Affordable Care Act (PPACA),signed March 23,2010,and the Health Care and Education Reconciliation Act of 2010,which amended the PPACA and became law on March 30,2010.
Andrew M. Slavitt is an American businessman and healthcare advisor who was the acting administrator of the Centers for Medicare and Medicaid Services from March 2015 to January 2017 and as a temporary Senior Advisor to the COVID-19 Response Coordinator in the Biden administration. A leader of the team that helped to repair the healthcare.gov website after its initial rollout,he was nominated by Barack Obama to run CMS in July 2015. In January 2021,Slavitt accepted a temporary role as Senior Pandemic Advisor to President Joe Biden’s COVID-19 pandemic response team. He stepped down from that role in June 2021.
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".
The Center for Medicare and Medicaid Innovation is an organization of the United States government under the Centers for Medicare and Medicaid Services (CMS). It was created by the Patient Protection and Affordable Care Act,the 2010 U.S. health care reform legislation. CMS provides healthcare coverage to more than 100 million Americans through Medicare,Medicaid,the Children’s Health Insurance Program (CHIP),and the Health Insurance Marketplace.
The Affordable Care Act (ACA) is divided into 10 titles and contains provisions that became effective immediately,90 days after enactment,and six months after enactment,as well as provisions phased in through to 2020. Below are some of the key provisions of the ACA. For simplicity,the amendments in the Health Care and Education Reconciliation Act of 2010 are integrated into this timeline.
Aducanumab,sold under the brand name Aduhelm,is a monoclonal antibody designed to treat Alzheimer's disease. It is a monoclonal antibody that targets aggregated forms (plaque) of amyloid beta (Aβ) found in the brains of people with Alzheimer's disease to reduce its buildup. It was developed by Biogen and Eisai. Aducanumab is given via intravenous infusion.
Robert McKinnon Califf is an American cardiologist who served as the 25th commissioner of food and drugs from 2016 to 2017 and again from 2022 to 2025.
Seema Verma is a General Manager and Executive Vice President at Oracle Corporation. She was administrator of the Centers for Medicare &Medicaid Services in the first Donald Trump administration. During her tenure,she was involved in efforts to repeal the Affordable Care Act,as well as reduce Medicaid benefits and increase restrictions on Medicaid. She was embroiled in ethics and legal controversies related to her use of taxpayer money while in office.
Elizabeth Richter is an American government official who served as the acting administrator of the Centers for Medicare &Medicaid Services from January to May 2021.
Lee Alan Fleisher is an American anesthesiologist and health policy expert. In 2020,Fleisher was named Chief Medical Officer and Director of the Centers for Medicare &Medicaid Services Center for Clinical Standards and Quality. He previously served as Chair of Anesthesiology and Critical Care at the Perelman School of Medicine at the University of Pennsylvania and continues to practice clinically. He is also the Founding Principal and CEO at Rubrum Advising.
