Category: H

The federal agency within the US Public Health Service (PHS) which deeds with issues relating to access, equity, quality, and cost of care. HRSA supports States and local communities in their efforts to organize and deliver health care, especially to underserved populations and other groups with special health needs, such as mothers and children. HRSA…

A facility providing some kind of health care to inpatients who do not require full nursing services.  

A person who analyzes data from medical records and other sources for hospital management and medical staff. An HRA may abstract data from the records for computer input; however, analysis and abstracting are distinctly different functions, ordinarily carried out by different people. Analysis requires interpretation, while abstracting is basically a clerical function. An HRA is…

An urban or rural area, population, or public or private nonprofit medical facility which the Secretary of the Department of Health and Human Services (DHHS) determines has a shortage of health care professionals. 42 CFR § 5. The Code of Federal Regulations provides the guidelines under which an area can be deemed to have a…

A program spearheaded by the American Medical Association (AMA) in the mid-1980’s to develop a set of proposals for improving health and health care in America. Among organizations represented in the policy-making process were the American Association of Retired Persons (AARP), American Nurses Association (ANA), Blue Cross and Blue Shield Association (BC/BSA), Business Roundtable, Health…

A set of information about a managed care plan (MCP) designed to serve as a “report card” for the plan. HEDIS 2.5 has 9 quality measures, 5 measures of access and patient satisfaction, 20 measures of membership and utilization, 15 measures of finance, and 15 measures of plant management, for a total of 64 measures.…

The model act developed by the National Association of Insurance Commissioners (NAIC) which has been used by most states as a pattern for their health maintenance organization (HMO) legislation. The model act requires the HMO to have a certificate of authority to do business in the state and requires detailed information to be provided to…

A nonprofit organization developing standards for the electronic interchange of clinical, financial, and administrative information among differing computer systems and applications in the health care industry. “Level Seven” is a reference to the application level, the highest level of the communications model for Open Systems Interconnection (OSI) of the International Organization for Standardization (ISO).  

The federal fund which pays for Medicare Hospital Insurance (referred to as HI or Part A, the hospital portion) of Medicare. Part B of Medicare (sometimes referred to as SMI), which pays for physician services, diagnostic tests and other outpatient services, is paid for by premiums received from beneficiaries, with the balance coming from the…

A state agency which sets standards and issues permits for the operation of health facilities.