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1 | Provided by Holistic Data-Driven Healthcare Last update: | 5/16/2025 12:50:26 | https://www.linkedin.com/in/jazon/ | ||
2 | Acronym | Meaning | Definition | Insight | |
3 | AAFP | American Academy of Family Physicians | A professional medical association representing family physicians, medical students, and residents in the United States. | AAFP is central to care delivery and operations. It helps clarify 'American Academy of Family Physicians' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
4 | ABG | Arterial Blood Gas | A blood test that measures the acidity (pH) and the levels of oxygen and carbon dioxide in arterial blood. | ABG is central to general healthcare operations. It helps clarify 'Arterial Blood Gas' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
5 | ACA | Affordable Care Act | Also known as Obamacare, it is a US healthcare reform law aimed at increasing the quality and affordability of health insurance, expanding Medicaid eligibility, and reducing the overall number of uninsured individuals in the United States. | ACA is central to policy and reimbursement. It helps clarify 'Affordable Care Act' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
6 | ACDM | Association for Clinical Data Management | Which promotes standards and best practices for managing clinical trial data to ensure accuracy and reliability. | ACDM is central to health IT and interoperability. It helps clarify 'Association for Clinical Data Management' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
7 | ACO | Accountable Care Organization | A group of healthcare providers who come together voluntarily to provide coordinated care to patients and share responsibility for the quality and cost of that care. | ACO is central to care delivery and operations. It helps clarify 'Accountable Care Organization' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
8 | ACO REACH | Accountable Care Organization Realizing Equity, Access, and Community Health | A CMS Innovation Center model that builds on the Global and Professional Direct Contracting (GPDC) model, explicitly incorporating health equity, community engagement, and accountable care for underserved populations. | ACO REACH represents the federal government’s most equity-forward payment reform initiative to date. It incentivizes providers to assume financial and clinical accountability for populations, but with added emphasis on closing disparities, collecting social needs data, and engaging community-based organizations. For new entrants and legacy health systems alike, understanding ACO REACH is essential to aligning with CMS’s value-based care future, where outcomes and equity are no longer parallel goals—they’re intertwined. | |
9 | ADL | Activities of Daily Living | Basic self-care tasks such as bathing, dressing, eating, and mobility, used to assess functional status. | ADL is commonly used in functional assessment and patient-centered care. It helps translate 'Activities of Daily Living' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
10 | ADR | Adverse Drug Reaction | An unintended and harmful reaction to a medication, vaccine, or other healthcare product, occurring at doses normally used for treatment, prevention, or diagnosis. | ADR is central to general healthcare operations. It helps clarify 'Adverse Drug Reaction' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
11 | ADT | Admission, Discharge, and Transfer | A set of core health information events tracked within healthcare systems, particularly electronic health records (EHRs), to document when a patient is admitted to, discharged from, or transferred within or between care settings. | ADT feeds are foundational to real-time care coordination, population health management, and interoperability. They trigger alerts for case managers, support transitions of care, and are increasingly used in risk stratification and predictive analytics. For outsiders, ADT data is the digital pulse of patient movement—powering everything from quality reporting to payer oversight in modern healthcare infrastructure. | |
12 | AE | Adverse Event | An unintended injury or complication resulting in harm to a patient caused by medical management rather than the patient’s condition. | AE is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Adverse Event' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
13 | AEP | Annual Enrollment Period | A time each year when individuals can enroll in or make changes to their Medicare Advantage or Part D prescription drug plans. It typically runs from October 15 to December 7, and any changes made during this period take effect on January 1 of the following year. | AEP is central to policy and reimbursement. It helps clarify 'Annual Enrollment Period' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
14 | AHRQ | Agency for Healthcare Research and Quality | A federal agency under the U.S. Department of Health and Human Services that conducts and funds research to improve the quality, safety, efficiency, and effectiveness of healthcare. | AHRQ is a cornerstone of evidence-based care. It develops clinical guidelines, patient safety tools, and quality measures that influence everything from hospital practices to national policy. For outsiders, AHRQ is like the R&D lab of American healthcare—quietly shaping what works, what’s safe, and what should change. | |
15 | AIM | Advanced Imaging Management | Programs that manage the use and quality of advanced imaging services, often as part of utilization management. | AIM is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Advanced Imaging Management' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
16 | AIP | Advanced Illness Program | A care model designed to support individuals with serious, progressive illnesses who may not yet be eligible for hospice. It typically includes palliative care, care coordination, symptom management, and support for patients and families in home or community settings. | AIPs bridge the gap between curative and end-of-life care—improving quality of life, reducing unnecessary hospitalizations, and aligning treatment with patient goals. For outsiders, think of AIP as healthcare’s way of honoring dignity before decline—personalized support when aggressive treatment is no longer the best path forward. | |
17 | ALOS | Average Length of Stay | The average number of days that patients remain in a hospital or care facility during a single episode of care. It’s a key metric used to measure efficiency, resource utilization, and care outcomes in inpatient settings. Lower ALOS can indicate more efficient care delivery—if not at the expense of quality. | ALOS is central to care delivery and operations. It helps clarify 'Average Length of Stay' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
18 | ALR | Assisted Living Residence | A residential facility that provides housing, personal care services, and health-related services to individuals who need help with daily activities but don’t require full-time nursing care. | ALR is central to general healthcare operations. It helps clarify 'Assisted Living Residence' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
19 | ALS | Advanced Life Support | A level of medical care that is more invasive than basic life support and is typically provided by paramedics or emergency medical technicians (EMTs) in an ambulance setting. | ALS is central to general healthcare operations. It helps clarify 'Advanced Life Support' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
20 | AMA | American Medical Association | A national organization that represents physicians and sets standards for medical ethics, practice, and education. | AMA is commonly used in clinical standards and provider guidance. It helps translate 'American Medical Association' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
21 | AOM | Anti-Obesity Medication | Medications prescribed to treat obesity by targeting mechanisms like appetite suppression, metabolic regulation, or nutrient absorption. Notable examples include GLP-1 receptor agonists such as Wegovy, Ozempic, and Zepbound. | AOMs are transforming obesity from a lifestyle issue to a clinically managed chronic condition. Their rapid adoption impacts formularies, reimbursement models, and long-term cost projections for payers. For outsiders, AOMs represent a seismic shift in chronic disease prevention—potentially lowering downstream costs for diabetes, cardiovascular disease, and more, but raising short-term questions about access, coverage equity, and ROI. | |
22 | APC | Ambulatory Payment Classification | A Medicare payment classification for outpatient services provided in hospital outpatient departments. | APC is commonly used in reimbursement and insurance operations. It helps translate 'Ambulatory Payment Classification' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
23 | APDRG | All Patient Diagnosis-Related Groups | An expanded version of DRGs that includes a broader patient population, including pediatric and non-Medicare cases. Commonly used in Medicaid and commercial insurance programs. | APDRG is central to policy and reimbursement. It helps clarify 'All Patient Diagnosis-Related Groups' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
24 | API | Application Programming Interface | A set of rules and protocols that allows different software applications to communicate and share data with each other, enabling integration and interoperability between healthcare systems. | API is central to health IT and interoperability. It helps clarify 'Application Programming Interface' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
25 | APM | Alternative Payment Model | A payment approach that provides financial incentives for healthcare providers to deliver high-quality, cost-effective care. APMs are one of the two tracks in the Quality Payment Program (QPP) under MACRA. | APM is central to care delivery and operations. It helps clarify 'Alternative Payment Model' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
26 | AQC | Alternative Quality Contract | A payment model used by health insurers to reimburse healthcare providers based on the quality and value of care delivered, rather than the volume of services provided. It aligns with the goals of ACA and emphasizes quality improvement and cost containment. | AQC is central to care delivery and operations. It helps clarify 'Alternative Quality Contract' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
27 | AR | Accounts Receivable | Money owed to a healthcare provider for services already delivered, awaiting payment from patients or insurers. | AR is commonly used in administrative and financial workflows. It helps translate 'Accounts Receivable' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
28 | Archer MSA | Archer Medical Savings Account | A type of tax-deferred savings account established for self-employed individuals or employees of small businesses with a high-deductible health plan (HDHP). Funds deposited can be used to pay for qualified medical expenses, and unused funds roll over year to year. | Named after Congressman Bill Archer, this account was the precursor to Health Savings Accounts (HSAs) and helped catalyze the consumer-directed healthcare movement. While no new Archer MSAs can be created today, existing ones remain active for eligible users. For outsiders, Archer MSAs illustrate how policy experimentation with personal health finance models has evolved to promote cost awareness, preventive care spending, and financial autonomy in healthcare. | |
29 | ASAM | American Society of Addiction Medicine | A professional society that sets clinical standards and guidelines for addiction medicine. | ASAM is commonly used in clinical standards and provider guidance. It helps translate 'American Society of Addiction Medicine' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
30 | AWV | Annual Wellness Visit | A yearly appointment covered by Medicare that focuses on preventive care. During the AWV, healthcare providers review a patient's medical history, perform screenings, and create or update a personalized prevention plan to help prevent disease and promote health. This visit does not involve a physical exam but emphasizes health assessments and planning. | AWV is central to policy and reimbursement. It helps clarify 'Annual Wellness Visit' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
31 | BAA | Business Associate Agreement | A legally required contract under HIPAA between a covered entity (like a health plan or provider) and a business associate (such as a vendor or contractor) that outlines each party’s responsibilities for protecting protected health information (PHI). | BAAs are critical compliance instruments in healthcare’s digital ecosystem. They ensure that any third party handling PHI meets privacy, security, and breach notification standards, reducing legal and financial risk. For outsiders, a BAA is the gatekeeper for trust and legal access to health data—making it foundational to health IT, data analytics, and digital health partnerships. | |
32 | BI | Business Intelligence | Technologies and strategies used to analyze data and provide actionable insights to improve decision-making within organizations. | BI is central to health IT and interoperability. It helps clarify 'Business Intelligence' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
33 | BLS | Basic Life Support | Immediate care provided to a victim of illness or injury until professional medical assistance arrives. | BLS is central to general healthcare operations. It helps clarify 'Basic Life Support' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
34 | BPCI | Bundled Payments for Care Improvement | A CMS initiative that tests bundled payments for episodes of care that involve multiple providers and settings. | BPCI is central to care delivery and operations. It helps clarify 'Bundled Payments for Care Improvement' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
35 | BPMH | Best Possible Medication History | A comprehensive medication history gathered to ensure accuracy at care transitions or admission. | BPMH is commonly used in functional assessment and patient-centered care. It helps translate 'Best Possible Medication History' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
36 | CAC | Customer Acquisition Cost | The total cost of acquiring a new customer or member, including marketing, sales, and onboarding expenses. | In healthcare, CAC is vital for health plans, providers, and D2C digital health companies to understand whether growth strategies are sustainable. A low CAC is critical when margins are slim, such as in Medicaid managed care or narrow network plans. | |
37 | CAH | Critical Access Hospital | A federal designation for small, rural hospitals that meet specific criteria—including distance from other hospitals and limited inpatient capacity—to ensure access to essential healthcare services in underserved areas. | CAHs receive cost-based reimbursement from Medicare rather than prospective payment, helping them remain financially viable despite low patient volumes. They are linchpins in rural health strategy, often serving as the only acute care option within a wide geographic area. For outsiders, CAHs exemplify how policy adapts to address geographic health disparities, reinforcing healthcare equity and local resilience in medically underserved regions. | |
38 | CAHPS | Consumer Assessment of Healthcare Providers and Systems | Surveys evaluating patient experiences across healthcare services, helping organizations enhance care quality. | CAHPS is central to general healthcare operations. It helps clarify 'Consumer Assessment of Healthcare Providers and Systems' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
39 | CAP | Corrective Action Plan | A structured plan required to correct deficiencies found during audits or inspections. | CAP is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Corrective Action Plan' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
40 | CBT | Cognitive Behavioral Therapy | A type of psychotherapy that helps individuals identify and change negative thought patterns and behaviors. | CBT is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Cognitive Behavioral Therapy' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
41 | CCM | Chronic Care Management | Services provided to Medicare beneficiaries with two or more chronic conditions to help manage their health conditions. | CCM is central to policy and reimbursement. It helps clarify 'Chronic Care Management' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
42 | CCO | Coordinated Care Organization | A network of healthcare providers that coordinates physical, behavioral, and oral health care for Medicaid members. | CCO is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Coordinated Care Organization' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
43 | CDC | Centers for Disease Control and Prevention | A federal agency under the US Department of Health and Human Services responsible for protecting public health and safety by providing information to enhance health decisions, and promoting health through partnerships with state health departments and other organizations. | CDC is central to general healthcare operations. It helps clarify 'Centers for Disease Control and Prevention' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
44 | CDHP | Consumer-Directed Health Plan | A health insurance plan that combines a high-deductible policy with a health savings account or reimbursement arrangement. | CDHP is commonly used in reimbursement and insurance operations. It helps translate 'Consumer-Directed Health Plan' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
45 | CDI | Clinical Documentation Improvement | The process of ensuring that healthcare documentation accurately reflects the clinical status and treatment of patients, which is essential for accurate coding, billing, and data analysis. | CDI is central to health IT and interoperability. It helps clarify 'Clinical Documentation Improvement' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
46 | CDS | Clinical Decision Support | Computer-based tools and systems that assist healthcare providers in making clinical decisions by providing relevant clinical knowledge and patient-specific information. | CDS is central to care delivery and operations. It helps clarify 'Clinical Decision Support' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
47 | CDSS | Clinical Decision Support System | Software tools designed to assist healthcare professionals in making clinical decisions by providing relevant patient-specific information, guidelines, and recommendations at the point of care. | CDSS is central to care delivery and operations. It helps clarify 'Clinical Decision Support System' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
48 | CEHRT | Certified Electronic Health Record Technology | EHR systems certified to meet the requirements established by CMS and ONC for data capture, sharing, and reporting. | CEHRT is commonly used in reimbursement and insurance operations. It helps translate 'Certified Electronic Health Record Technology' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
49 | CHIP | Children's Health Insurance Program | US government program that provides low-cost or free health coverage to children in families with incomes too high to qualify for Medicaid but who can't afford private insurance. | CHIP is central to policy and reimbursement. It helps clarify 'Children's Health Insurance Program' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
50 | CHIPRA | Children’s Health Insurance Program Reauthorization Act | A law that reauthorized and expanded the Children’s Health Insurance Program (CHIP), providing coverage for low-income children. | CHIPRA is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Children’s Health Insurance Program Reauthorization Act' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
51 | CHNA | Community Health Needs Assessment | A systematic process used by hospitals and healthcare organizations to identify and prioritize the health needs of their communities, often required as part of the Affordable Care Act (ACA) regulations. | CHNA is central to care delivery and operations. It helps clarify 'Community Health Needs Assessment' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
52 | CIN | Clinically Integrated Network | A network of healthcare providers that collaborate to improve care quality and reduce costs while maintaining legal independence. | CIN is central to care delivery and operations. It helps clarify 'Clinically Integrated Network' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
53 | CLIA | Clinical Laboratory Improvement Amendments | Federal standards for all U.S. facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. | CLIA is central to general healthcare operations. It helps clarify 'Clinical Laboratory Improvement Amendments' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
54 | CM | Case Management | Involves coordinating healthcare services for patients, often those with complex medical needs, to ensure they receive comprehensive and appropriate care. | CM is central to general healthcare operations. It helps clarify 'Case Management' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
55 | CMIO | Chief Medical Information Officer | A senior executive responsible for overseeing the implementation and management of healthcare information technology systems within a healthcare organization. | CMIO is central to general healthcare operations. It helps clarify 'Chief Medical Information Officer' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
56 | CMMI | Center for Medicare and Medicaid Innovation | A division within the Centers for Medicare & Medicaid Services (CMS) responsible for developing and testing new payment and service delivery models to improve care quality and reduce costs across Medicare, Medicaid, and CHIP. | CMMI is the R&D arm of U.S. healthcare policy—piloting innovations like ACOs, bundled payments, and health equity models. For outsiders, it’s where bold ideas get tested at national scale. Understanding CMMI is key to anticipating where value-based care and federal reimbursement are headed next. | |
57 | CMS | Centers for Medicare & Medicaid Services | A federal agency within the US Department of Health and Human Services responsible for administering Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). | CMS is central to policy and reimbursement. It helps clarify 'Centers for Medicare & Medicaid Services' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
58 | CMS-1500 | Standard Medical Claim Form | Standardized claim form used by non-institutional providers (e.g., physicians, outpatient clinics) to bill Medicare and many private insurers for medical services. It captures essential patient, provider, and service information in a structured format to support consistent processing and reimbursement. | CMS-1500 is central to policy and reimbursement. It helps clarify 'Standard Medical Claim Form' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
59 | CMSA | Case Management Society of America | An organization that supports the practice of case management across healthcare settings. | CMSA is commonly used in clinical standards and provider guidance. It helps translate 'Case Management Society of America' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
60 | CNS | Central Nervous System | Part of the nervous system comprising the brain and spinal cord, crucial in coordinating bodily functions. | CNS is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Central Nervous System' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
61 | COB | Coordination of Benefits | A process to determine the order of payment responsibility when a patient is covered by more than one insurance plan. | COB is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Coordination of Benefits' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
62 | COBRA | Consolidated Omnibus Budget Reconciliation Act | A US law that allows employees and their dependents to continue receiving health insurance coverage for a limited time after experiencing a qualifying event (such as job loss) that would otherwise result in loss of coverage. | COBRA is central to general healthcare operations. It helps clarify 'Consolidated Omnibus Budget Reconciliation Act' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
63 | COI | Continuity of Information | The seamless transfer and continuity of healthcare information between providers during transitions in care. | COI is commonly used in data interoperability, privacy, and analytics. It helps translate 'Continuity of Information' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
64 | COPD | Chronic Obstructive Pulmonary Disease | A progressive, chronic inflammatory lung disease—typically caused by long-term exposure to irritants like cigarette smoke—that obstructs airflow and makes breathing difficult. It includes conditions such as emphysema and chronic bronchitis. | COPD is a leading cause of morbidity, hospitalizations, and healthcare spending, especially among older adults. It’s a target condition in many value-based care programs, HEDIS measures, and care coordination initiatives, due to its impact on quality of life and preventable exacerbations. For outsiders, COPD exemplifies the intersection of chronic disease management, patient education, and preventive care, all critical to achieving cost-effective, high-quality outcomes. | |
65 | CPC | Comprehensive Primary Care | A multi-payer initiative developed by CMS to improve primary care delivery by supporting care coordination, access, patient engagement, and data-driven decision-making. CPC evolved into models like CPC+ and now the Primary Care First initiative. | CPC represents a strategic move from volume to value in primary care, rewarding practices for improved outcomes and lower costs rather than visit volume. It emphasizes team-based care, health IT use, and population health management. For outsiders, CPC is a blueprint for how primary care transformation underpins broader healthcare reform—serving as the front line for equity, chronic care, and patient-centered innovation. | |
66 | CPI | Consumer Price Index | An index measuring average change in prices paid by consumers over time for goods and services, including medical care. | CPI is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Consumer Price Index' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
67 | CPT | Current Procedural Terminology | A set of medical codes maintained by the American Medical Association (AMA) used to describe medical, surgical, and diagnostic services provided by healthcare providers, for the purpose of billing and reimbursement. | CPT is central to care delivery and operations. It helps clarify 'Current Procedural Terminology' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
68 | CRC | Certified Risk Coder | A professional credential awarded by the AAPC (American Academy of Professional Coders) that certifies expertise in risk adjustment coding, particularly for Medicare Advantage, ACA marketplace plans, and other value-based payment models. | CRC-certified coders play a critical role in accurate HCC coding, RAF score optimization, and documentation integrity, directly impacting plan revenue and regulatory compliance. As risk adjustment becomes more central to healthcare financing, CRCs are increasingly valued in health plans, provider groups, and RCM firms. For outsiders, CRCs are the translators of clinical complexity into financial reality—essential for aligning care documentation with reimbursement in value-based care. | |
69 | CRT | Certified Respiratory Therapist | A healthcare professional certified in providing respiratory therapy services to patients with breathing issues. | CRT is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Certified Respiratory Therapist' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
70 | CSP | Contracted Service Provider | An external service provider contracted by a healthcare organization to deliver specific healthcare or support services. | CSP is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Contracted Service Provider' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
71 | CT | Computed Tomography | A diagnostic imaging test that uses X-rays and computer technology to produce cross-sectional images of the body. | CT is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Computed Tomography' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
72 | CTM | Care Transition Measure | Tool gauging care transition quality for patients moving between healthcare settings, aiming to improve coordination, communication, and patient outcomes. | CTM is central to general healthcare operations. It helps clarify 'Care Transition Measure' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
73 | CTR | Click-Through Rate | The percentage of people who click on a link, ad, or call-to-action after seeing it. | In healthcare, CTR matters for digital outreach—especially patient acquisition, wellness program engagement, or plan marketing campaigns. A strong CTR can indicate that health messaging or plan options are resonating with the target audience. | |
74 | DAV | Data Aggregator Vendor | A DAV is a vendor that collects and aggregates healthcare data from multiple sources, such as electronic health records, claims data, and pharmacy records. DAVs play a key role in providing data analytics and population health management services to healthcare organizations. | DAV is central to health IT and interoperability. It helps clarify 'Data Aggregator Vendor' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
75 | DC | Discharge | The formal release of a patient from a hospital or care facility once treatment goals are met or care is transitioned. | DC is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Discharge' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
76 | DEA | Drug Enforcement Administration | A U.S. federal agency regulating controlled substances and enforcing drug laws, including provider registration. | DEA is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Drug Enforcement Administration' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
77 | DHHS | Department of Health and Human Services | The U.S. government department overseeing public health, welfare, and health policy through agencies like CMS and CDC. | DHHS is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Department of Health and Human Services' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
78 | DICOM | Digital Imaging and Communications in Medicine | A standard for the exchange, storage, and communication of medical images and related information between imaging devices, computers, and other healthcare systems. | DICOM is central to health IT and interoperability. It helps clarify 'Digital Imaging and Communications in Medicine' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
79 | DLT | Delayed Treatment | A delay in the delivery of timely healthcare services, often due to operational, clinical, or systemic factors. | DLT is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Delayed Treatment' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
80 | DME | Durable Medical Equipment | Medical equipment that is prescribed by a healthcare provider for use in the home, and is intended for repeated use, such as wheelchairs, hospital beds, and oxygen equipment. | DME is central to care delivery and operations. It helps clarify 'Durable Medical Equipment' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
81 | DMS | Document Management System | Software used to store, manage, and track electronic documents and images, including healthcare-related documents such as medical records, reports, and administrative files. | DMS is central to general healthcare operations. It helps clarify 'Document Management System' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
82 | DO | Doctor of Osteopathic Medicine | A licensed physician who practices a whole-person approach to treatment, trained in osteopathic manipulative medicine. | DO is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Doctor of Osteopathic Medicine' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
83 | DOB | Date of Birth | A standard patient identifier used in medical records, scheduling, and eligibility verification. | DOB is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Date of Birth' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
84 | dQM | Data Quality Management | Refers to the processes, technologies, and strategies implemented to ensure the accuracy, completeness, consistency, and reliability of data within an organization. | DQM is central to health IT and interoperability. It helps clarify 'Data Quality Management' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
85 | DRG | Diagnosis-Related Group | A classification system that groups inpatient hospital cases into categories based on diagnosis, procedures, age, and other factors, which are used by Medicare and other payers to determine fixed reimbursement rates for hospital stays. | DRGs are the foundation of Medicare's Inpatient Prospective Payment System (IPPS), incentivizing hospitals to manage costs efficiently while maintaining quality. For stakeholders, understanding DRGs is essential to navigating clinical documentation, revenue cycle management, and bundled payment strategies. For outsiders, DRGs represent how government payers turn complex medical episodes into predictable financial transactions—driving operational behavior and care standardization across hospitals. | |
86 | DSH | Disproportionate Share Hospital | A hospital that serves a significantly large number of low-income or uninsured patients and receives additional Medicaid and Medicare funding to offset the financial burden of uncompensated care. | DSH payments are a lifeline for safety-net hospitals, especially in urban and rural areas where health disparities are concentrated. These funds help ensure access to essential services for vulnerable populations, including the uninsured and Medicaid beneficiaries. For policy analysts and health system leaders, DSH reflects the intersection of finance, equity, and access, and plays a pivotal role in the broader conversation about how healthcare systems support underserved communities. | |
87 | DSHP | Designated State Health Programs | Are state-funded health initiatives that, under approved Medicaid 1115 waivers, could temporarily receive federal matching funds—even though they're not part of Medicaid. States used DSHPs to finance innovations like workforce training or public health programs. | DSHP is central to policy and reimbursement. It helps clarify 'Designated State Health Programs' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
88 | DSIP | Designated State Initiatives Pool | Refers to a funding mechanism within Medicaid Section 1115 waivers that allows states to claim federal matching funds for certain state-driven health initiatives—similar to DSHPs, but often focused on broader transformation efforts such as system reform, infrastructure, or delivery innovation. | DSIP is central to policy and reimbursement. It helps clarify 'Designated State Initiatives Pool' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
89 | DSMES | Diabetes Self-Management Education and Support | Designed to help people with diabetes manage their condition effectively. It focuses on collaborating with healthcare teams, making informed decisions, problem-solving, setting personal goals, and coping with emotions and stress. DSMES aims to enhance self-management behaviors, improving overall health and quality of life. | DSMES is central to general healthcare operations. It helps clarify 'Diabetes Self-Management Education and Support' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
90 | DSMT | Diabetes Self-Management Training | Structured educational programs to help patients with diabetes improve self-care and glycemic control. | DSMT is commonly used in functional assessment and patient-centered care. It helps translate 'Diabetes Self-Management Training' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
91 | DSNP | Dual Eligible Special Needs Plan | A Medicare Advantage plan for individuals eligible for both Medicare and Medicaid. | DSNP is central to policy and reimbursement. It helps clarify 'Dual Eligible Special Needs Plan' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
92 | DSRIP | Delivery System Reform Incentive Payment | A CMS program that provides funding to states to implement delivery system reforms that improve healthcare quality and reduce costs for Medicaid beneficiaries. | DSRIP is central to policy and reimbursement. It helps clarify 'Delivery System Reform Incentive Payment' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
93 | DTx | Digital Therapeutics | Evidence-based software-driven interventions designed to prevent, manage, or treat medical disorders or diseases. Unlike wellness apps, DTx products undergo clinical validation and are often regulated by the FDA. | DTx represents a paradigm shift in care delivery, offering scalable, personalized treatment options for chronic conditions like diabetes, ADHD, insomnia, and substance use disorders. They are increasingly integrated into payer formularies, care pathways, and value-based contracts. For outsiders, DTx is where technology meets therapeutics, redefining how care is accessed, delivered, and reimbursed—particularly in a post-COVID digital-first era. | |
94 | DX | Diagnosis | The identification of a disease or condition by a medical professional. | DX is central to general healthcare operations. It helps clarify 'Diagnosis' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
95 | DXA | Dual-energy X-ray Absorptiometry | A scan used to measure bone mineral density, primarily to diagnose osteoporosis and assess fracture risk. | DXA is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Dual-energy X-ray Absorptiometry' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
96 | E&M | Evaluation and Management | A category of CPT (Current Procedural Terminology) codes used by healthcare providers to document and bill for patient encounters that involve assessing and managing a patient’s health, such as office visits, hospital consultations, and preventive checkups. | E&M coding is the financial core of clinical practice, especially in primary care and specialty medicine. It affects reimbursement rates, audit risk, and care classification under both fee-for-service and value-based payment models. For outsiders, E&M captures how medical decision-making, complexity, and time are quantified into billable services—making it essential to both clinical documentation and healthcare economics. | |
97 | EBM | Evidence-Based Medicine | Medical practice based on integrating clinical expertise with the best available evidence from systematic research. | EBM is central to care delivery and operations. It helps clarify 'Evidence-Based Medicine' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
98 | ECOG | Eastern Cooperative Oncology Group | A scale to assess a patient’s functional status and ability to perform daily activities, often in cancer care. | ECOG is commonly used in healthcare delivery, operations, or oversight. It helps translate 'Eastern Cooperative Oncology Group' into practical applications, helping healthcare professionals and systems manage clinical, operational, or financial workflows more effectively. | |
99 | ED | Emergency Department | A hospital unit for providing immediate treatment to acute illnesses and trauma. | ED is central to care delivery and operations. It helps clarify 'Emergency Department' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. | |
100 | EDI | Electronic Data Interchange | The electronic exchange of healthcare data between different computer systems or organizations, often used for administrative and financial transactions. | EDI is central to health IT and interoperability. It helps clarify 'Electronic Data Interchange' and guides stakeholders in navigating regulatory, clinical, or operational decisions. Understanding this term improves alignment across healthcare transformation efforts. |