Word of the day

Thursday, August 20

Cadillac Health Plan

A colloquial term for expensive health plans – with generous benefits. The Affordable Care Act puts a tax on employer-sponsored plans with total premiums over an adjusted price starting in 2018.

Tuesday, August 18

Cadillac Tax

The High Cost Plan Excise Tax, which is often referred to as the “Cadillac Tax” is one of the revenue raising provisions in the 2010 Patient Protection and Affordable Care Act. The excise tax is calculated by comparing the cost of an employer-sponsored plan (which includes premiums paid by the employer and/or employee as well as any contributions into health accounts such as health savings accounts of flex savings accounts) to a benchmark, which will be adjusted every year based on the Consumer Product Index (CPI). Any amount above the benchmark is taxed at 40 percent; this tax is levied on the health insurance company but is generally understood to be passed onto the consumer, or firm purchasing that plan.

Monday, August 10

Health Information Technology (Health IT)

Networks and technology that allow for health care organizations to gather, store and share information electronically.

Friday, August 7

Pay for Performance

A health care payment method, which offers incentives to providers in exchange for meeting or exceeding the quality and cost benchmarks. Systems also punish providers for not meeting benchmarks in order to encourage the improvement of quality.

Wednesday, August 5

Fiscal Intermediary (FI)

Private insurance companies that are contracted to administer and handle Medicare claims.

Tuesday, August 4

Maximum Reimbursable Charge

Dollar limit on health care services, typically only applies to out of network coverage.

Monday, August 3

Joint Commission on Accreditation of Health Care Organizations (JCAHO)

Aims to improve the care provided by health care organizations and evaluates the compliance of an organization with the set standards.

Friday, July 31

Physician Assistant

A health care professional that can provide basic health care but is not authorized to do so without the supervision of a licensed physician.

Thursday, July 30

Vertical Integration

Control of a large portion of the supply chain for a product. As it applies to health care, companies might control insurance, hospitals, and clinics.

Monday, July 27

Acute Episodes of Care

Timeframe encompassing the treatment period for a major health problem. These episodes are most commonly surrounding surgery and include pre- and post- surgical tests and post-operative care in addition to the surgery itself.

Pay or Play

Colloquial term for an ACA provision requiring employers to offer health insurance or pay a fine.