Definitions

ACO – Accountable Care Organization

ACO is a network in which doctors and hospitals assume shared responsibility for patient care. ACO’s would manage all the health care needs.

ACA – Affordable Care Act

The landmark but somewhat controversial legislation passed by congress and signed into law in March 2010.

AAMC– Association of American Medical Colleges

The AAMC serves and leads the academic medicine community to improve the health of all. The AAMC represents all 133 accredited U.S. and 17 accredited Canadian medical schools; approximately 400 major teaching hospitals and health systems, including 62 Department of Veterans Affairs medical centers; and nearly 90 academic and scientific societies.

Administrative Expense

Expenses incurred for managing business activities but not including costs of the goods or services produced. Referred to as overhead expense.

BEA – Bureau of Economic Analysis

BEA is an agency of the Department of Commerce. Along with the Census Bureau and STAT-USA, BEA is part of the Department’s Economics and Statistics Administration.

BLS – Bureau of Labor Statistics

The Bureau of Labor Statistics of the U.S. Department of Labor is the principal Federal agency responsible for measuring labor market activity, working conditions, and price changes in the economy. Its mission is to collect, analyze, and disseminate essential economic information to support public and private decision-making.

Business Equity

Used in analysis of wealth and income, it represents ownership interest in business.  In accounting terms, it is the difference between a business’ total assets minus its total liabilities, or simply equity.

CBO – Congressional Budget Office

CBO assists the House and Senate Budget Committees, and the Congress more generally, by preparing reports and analyses. In accordance with the CBO’s mandate to provide objective and impartial analysis, CBO’s reports contain no policy recommendations.

CCH  Almanac of Business Ratios

An annual book published by Commerce Clearing House. This comprehensive resource puts 50 comparative performance indicators at the practitioner’s command and covers all of North America using NAICS data to determine a company’s true measure of performance and value.

CDC – Centers for Disease Control

The CDC is one of the major operating components of the Department of Health and Human Services. It collaborates to create the expertise, information, and tools that people and communities need to protect their health – through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.

CMS – Centers for Medicare Medicaid Services

CMS is a federal agency within the United States Department of Health and Human Services (DHHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children’s Health Insurance Program (SCHIP), and health insurance portability standards.

Corporate Tax

Used in the context of taxes individuals may pay for income received from corporate sources (taxes on interest, dividends, and capital gains from investments),

Cost Control

Steps, procedures and rules taken to restrain cost increases or reduce costs. On this site, refers to medical costs.

Dartmouth Atlas of Healthcare

Dartmouth Atlas Project has documented glaring variations in how medical resources are distributed and used in the United States. The project uses Medicare data to provide information and analysis about national, regional, and local markets, as well as hospitals and their affiliated physicians.

Excess Profits

A subjective concept where the profit margin is considered excessive for the product or service rendered.  It cannot be determined in isolation but only in relation to similar enterprises whose profit margins are generally lower.Excise Tax
An excise is an indirect tax, meaning that the producer or seller who pays the tax to the government is expected to try to recover the tax by raising the price paid by the buyer. Examples are gasoline, cigarettes, and liquor.

Federal Mandate

“Federal mandate is defined as “any provision in statute or regulation or any Federal court ruling that imposes an enforceable duty upon State, local, or tribal governments including a condition of Federal assistance or a duty arising from participation in a voluntary Federal program.” (www.uslegal.com)

FED – Federal Reserve Syste

The Fed is the central banking system of the United States.

Financial Assets

Financial assets include CD’s, bonds, mutual funds, stocks, cash value life insurance, and retirement assets.

Financial Ratios

Statistical ratios to identify and compare financial performance of business.

GDP – Gross Domestic Product

The gross domestic product (GDP) or gross domestic income (GDI) is the amount of goods and services produced in a year, in a country. It is the market value of all final goods and services made within the borders of a country in a year.  (Wikipedia)

Health Costs

Generally meaning the cost of health care applicable to providers, insurers, business and individuals. See also “Medical Costs”

Health Promotion

Indirect costs that insurers incur to promote better health (and lower costs) that may be included in Medical costs.

Health Quality

Indirect costs that insurers incur to promote better healthcare outcomes that may be included in Medical costs.

Healthcare Reform

All efforts to change the status quo of the current health care system in the U.S. Most current focus has been on the provisions of the ACA – Affordable Care Act.

House

The United States House of Representatives

Household Income

Combined Income from all sources and from all members of a household.

Household Wealth

Combined wealth (savings and assets) from all sources and from all members of a household.

Illinois Pre-existing Condition Insurance Plan (IPXP)


Income Tax

Tax by federal and state governments on income earned single or jointly by persons.

Insurers – Insurance Cos.

Used in the context of this site, refers to Health care insurance companies, whether for profit or non-profit.

IRS – Internal Revenue Service

Do you really have to ask?

Kaiser State Health Facts

Kaiser Family Foundation is a non-profit, private operating foundation focusing on the major health care issues facing the U.S., as well as the U.S. role in global health policy.

Length Of Stay

A medial term defining how long a person is continuously hospitalized.

Mayo Clinic

A group of hospitals and doctors with a mission “To inspire hope and contribute to health and well-being by providing the best care to every patient through integrated clinical practice, education and research.”

Medicaid

Medicaid is the United States health program for eligible individuals and families with low incomes and resources. It is a means tested program that is jointly funded by the state and federal governments, and is managed by the states.(Wikipedia)

Medical Costs

When associated with the AHA health reform act, refers to insurers’ costs directly associated with health care. Costs that do not qualify are SG&A costs (overhead) required to manage business.

Medical Errors

Medical error is a preventable adverse effect of care, whether or not it is evident or harmful to the patient. Definition is subject to debate since this is a subjective measure open to different interpretations. (Wikipedia)

MLR – Medical Loss Ratio

MLR is a health insurance term referring to the ratio of medical costs divided by premiums.

Medical Risk

A health insurance term referring to the possibility of higher medical costs for one or a group of insured persons. Medical risk has two components – 1) probability of occurrence, and 2) consequence should there be an occurrence.

Medicare

See CMS Centers for Medicare Medicaid Services

Minimum Medical Loss Ratio

Under the ACA reform law, insurers will be required to spend a minimum amount of premium on actual medical costs and by extension, a maximum amount of premium on overhead expense and profits. A fair way to set that standard is to use a percent that takes into account low and high premium accounts.

NAIC – National Association Of Insurance Commissioners

NAIC commissioners are the elected or appointed state government officials who along with their departments and staff, regulate the conduct of insurance companies and agents in their respective state or territory.

NEJM – New England Journal of Medicine

The New England Journal of Medicine is the oldest continuously published medical periodical is dedicated to bringing physicians the best research and key information at the intersection of biomedical science and clinical practice, and to presenting the information in an understandable and clinically useful format

NIH – National Institutes of Health

The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nation’s medical research agency—making important medical discoveries that improve health and save lives.

NIPA – National Income and Product Accounts

Detailed statistical tables regarding GDP tracked by the BEA. BEA is an agency of the Department of Commerce. Along with the Census Bureau and STAT-USA, BEA is part of the Department’s Economics and Statistics Administration.

NPDB – National Practitioner Data Bank

National Practitioner Data Bank (NPDB) and the Healthcare Integrity and Protection Data Bank (HIPDB), is a confidential information clearinghouse created by Congress to improve health care quality, protect the public, and reduce health care fraud and abuse in the U.S.

OECD – Organization for Economic Co-operation and Development

34 OECD member plus 6 other countries worldwide regularly turn to one another to identify problems, discuss and analyze them, and promote policies to solve them. These 40 countries account for 80% of world trade and investment, giving it a pivotal role in addressing the challenges facing the world economy.

OMB – Office of Management and Budget

OMB is the largest component of the Executive Office of the President.  It reports directly to the President and helps a wide range of executive departments and agencies across the Federal Government to implement the commitments and priorities of the President

Premiums

As used on this site, is the amounts health insurers charge enrollees for health care protection.

Private Insurers

As used on this site, these are non-governmental health insurers, either for profit or nonprofit insurers.

Quality

One of the three key concerns for any reform of healthcare: quality, cost, and access. To maintain quality, decrease costs, and increase access.

Rationing

In the arena of Managed care, is the allocation or distribution of a scarce product, commodity or service.

ROE – Return on Equity

One of the financial ratios used to gauge a company’s performance.  The ratio ROE is a company’s net income divided by the company’s equity. Equity is total assets minus total liabilities.

ROI – Return on Investment

One of the financial ratios used to gauge a company’s performance.  The ratio ROI is a company’s net income divided by the company’s Investment. Investment is total assets minus current liabilities.

ROS – Return on Sales

One of the financial ratios used to gauge a company’s performance.  The ratio ROS is a company’s net income divided by the company’s net sales revenue.

Self-Insured

In health care terms, self insured are large companies who assume the risk of health care costs of their employees. They do this because those expected costs are likely less than health coverage purchased from an insurance company.

SG&A – Sales, General & Administrative Expense

Non productive overhead expenses associated with managing any business or enterprise.

SSA – Social Security Administration

The Social Security Act was signed into law by President Roosevelt on August 14, 1935. It created a social insurance program designed to pay retired workers age 65 or older a continuing income after retirement.

Social Security Tax

One of the taxes paid by companies and individuals as “premiums” used to fund social security retirement benefits.

Tort Reform

Tort reform refers to proposed changes in the civil justice system that would reduce tort litigation or damages. Tort is a system for compensating wrongs and harm done by one party to another’s person, property or other protected interests (Wikipedia)

Transparency

Making public the details of transactions that occur within organizations. In health care, reform requires posting on the internet of standard charges for all hospital and physician services.

U.S. Census Bureau

The Census Bureau serves as the leading source of quality data about the nation’s people and economy. Its site notes that it honors privacy, protects confidentiality, shares expertise globally, and conducts work openly.

WHO – World Health Organization

WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. (WHO website)

Yahoo Finance

A source of index information by industry by sector to compare relative performance of different sectors.

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