Glossary
Accountable Care Organization (ACO)
A group of healthcare providers, including doctors and hospitals, that voluntarily come together to provide coordinated, high-quality care to a designated group of patients, primarily those on Medicare - https://www.cms.gov/priorities/innovation/innovation-models/aco
Advanced Illness and Post-Acute Care (AdvIll and PAC)
Advanced Illness and Post-Acute Care is an E&M project that includes measures that focus on addressing the symptoms or stress related to the illness and improving the overall experience and/or quality of life for patients, caregivers, and family members. Advanced illness care may also include palliative and hospice care, which includes comprehensive care that addresses medical, emotional, spiritual, and social needs during the last stages of a person’s terminal illness.
Affordable Care Act (ACA)
The Patient Protection and Affordable Care Act, referred to as the Affordable Care Act or “ACA” for short, is the comprehensive health care reform law enacted in March 2010.
Agency for Healthcare Research and Quality (AHRQ)
An agency within the US Department of Health and Human Services. It was established to enhance the quality, appropriateness, and effectiveness of health care services and access to care by conducting and supporting research, demonstration projects, and evaluations; developing guidelines; and disseminating information on health care services and delivery systems. https://www.ahrq.gov/
Alignment
Alignment, with respect to quality measures, is encouraging the use of similar, standardized quality measures across and within public and private sector efforts. Achievement of alignment is when a set of measures works well across care settings or programs to produce meaningful information without creating extra work for measured entities. Alignment includes using the same quality measures in multiple programs when possible. It can also come from consistently measuring important topics across care settings.
Ambulatory Surgical Center Quality Reporting Program (ASCQR)
The Ambulatory Surgical Center Quality Reporting (ASCQR) Program was established under the authority provided by Section 109(b) of the Medicare Improvements and Extension Act of 2006, Division B, Title I of the Tax Relief and Health Care Act (TRHCA) of 2006. The statute provides the authority for requiring Ambulatory Surgical Centers (ASCs) paid under the ASC fee schedule to report data on services provided in this care setting.
American College of Cardiology (ACC)
The American College of Cardiology (ACC) is a nonprofit medical association established in 1949. It bestows credentials upon cardiovascular specialists who meet its qualifications. https://www.acc.org/
American Institutes for Research (AIR)
The American Institutes for Research (AIR) is a nonprofit, nonpartisan behavioral and social science research, evaluation, and technical assistance organization https://www.air.org/
American Society of Clinical Oncology (ASCO)
The American Society of Clinical Oncology (ASCO) is a professional organization representing physicians of all oncology sub-specialties who care for people with cancer. https://www.asco.org/
American's Health Insurance Plans (AHIP)
AHIP (formerly America's Health Insurance Plans) is an American political advocacy and trade association of health insurance companies that offer coverage through the employer-provided, Medicare Advantage, Medicaid managed care, and individual markets. https://www.ahip.org/
Analysis of Variance (ANOVA)
An ANOVA is a statistical test used to analyze the difference between the means of three or more groups. ANOVA can be one-way (one independent variable) or two-way (two independent variables). Bevans, R. (2023, June 22). One-way ANOVA. When and how to use it (with examples). Scribbr. Retrieved November 27, 2023, from https://www.scribbr.com/statistics/one-way-anova/#
Attribution
Attribution is the action of linking the treatments, processes, or outcomes of health care to one or more measured entity.
Audit
An audit is a systematic inspection of records or accounts to verify their accuracy.
Bootstrapping
Bootstrap analysis (bootstrapping), as used in risk adjustment models, generally refers to estimating properties of a model estimate or the stability of an estimate by sampling from an approximating distribution. The measure developer may accomplish this by constructing many resamples of equal size from the observed dataset (e.g., the development sample), when the resamples are smaller than the observed dataset. This technique allows estimation of the sample distribution of a statistic. Measure developers can also use it to construct hypothesis tests. In the case of a regression or logistic regression risk adjustment model, the measure developer can use it to provide additional guidance regarding the inclusion of risk factors in the model.
Business Case
A business case is a justification for a proposed project or undertaking on the basis of its expected commercial benefit. It exists if the entity realizes a financial return on its investment in a reasonable time frame. The entity may realize as profit, reduction in losses, or avoided costs. A business case may also exist if the investor believes a positive indirect effect on organizational function and sustainability will accrue within a reasonable time frame (Leatherman et al., 2003). The business case for a process measure relies on the financial return on the investment necessary to implement the intervention advocated by the measure. The business case for other types of measures relies on the financial return resulting from improving the quality of care indicated by the measure.
C-statistic
Measure developers use the C-statistic to assess risk-adjusted models, it indicates the ability of the model to discriminate between one event and the other. If a model discriminates randomly, c = 0.5. If the risk factor modeling predicts the outcome well, then discrimination increases. The higher the c-statistic, the better the predictive power of the model.
Calculation Algorithm
A calculation algorithm is an ordered sequence of data element retrieval and aggregation through which numerator and denominator events or continuous variable values are identified by a measure. Also referred to as the performance calculation.
Cardiovascular Disease (CVD)
Cardiovascular diseases (CVDs) encompass a broad range of conditions affecting the heart and blood vessels, often stemming from atherosclerosis. These conditions are a leading cause of death globally, with many being preventable through lifestyle modifications and early detection.
Centers for Disease Control and Prevention (CDC)
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency under the Department of Health and Human Services (HHS). https://www.cdc.gov/
Centers for Medicare & Medicaid Services (CMS)
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. https://www.cms.gov/
Chi-square test
Chi-square test measures the statistical significance of a difference in proportions. It is a statistical test commonly used to compare observed data with data one would expect to obtain according to a specific hypothesis. Pelletier, L. R., & Beaudin, C. L. (Eds.). (2012). Q solutions: Essential resources for the healthcare quality professional (3rd ed.). National Association for Healthcare Quality.
Clinical decision support (CDS)
Clinical decision support is health information technology functionality building upon the foundation of an electronic health record to provide persons involved in care processes with general and person-specific information, intelligently filtered and organized, at appropriate times, to enhance health and health care.
Clinical Decision Support System (CDSS)
A Clinical Decision Support System (CDSS) is a health information technology designed to assist healthcare professionals in making informed decisions by providing knowledge and patient-specific information at the point of care.
Clinical information systems (CIS)
Clinical information systems "are computer systems that provide immediate access to current patient data regarding clinical notes, medication history, laboratory reports, images, and reports either directly or via data networks. They are parts of a hospital information system, which facilitates direct patient care." Islam, M. M., Poly, T. N., & Li, Y-C. J. (2018). Recent advancement of clinical information systems: Opportunities and challenges. Yearbook of Medical Informatics, 27(1), https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-00…
Clinical Practice Guideline (CPG)
Clinical practice guidelines (CPGs) are systematically developed statements to assist clinician and patient decisions about appropriate health care for specific clinical circumstances. CPGs are statements that include recommendations intended to optimize patient care. They are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. Committee on Standards for Developing Trustworthy Clinical Practice Guidelines. (2011). Clinical practice guidelines we can trust. Institute of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK209539/pdf/Bookshelf_NBK209539.pdf