Glossary

A group health plan that covers employees of either an employer or employee organization that has 100 or more employees.

A group health plan that is sponsored jointly by two or more employers or by employers and employee organizations.

A group health plan that is sponsored jointly by two or more employers or by employers and unions.

A group of data elements that represent core items of a comprehensive
assessment for an adult home care patient and form the basis for measuring
patient outcomes for purposes of outcome-based quality improvement (OBQI).
This assessment is performed on every patient receiving services of Home Health agencies that are approved to participate in the Medicare and/or Medicaid programs.

A group of doctors, hospitals, and other health care providers that agree to give health care to Medicare beneficiaries for a set amount of money from Medicare every month. This type of managed care plan is run by the doctors and providers themselves, and not by an insurance company. (See Managed Care Plan.)

A group of doctors, hospitals, pharmacies, and other health care experts hired by a health plan to take care of its members.

A group of private organizations that make sure you are getting the best possible care. ESRD networks also keep your facility aware of important issues about kidney dialysis and transplants.

A group that promotes the development and improvement of state and national health information systems.

A health care industry association that represents the concerns of institutional providers. The AHA hosts the NUBC, which has a formal consultative role under HIPAA.

A health care industry group that has a formal consultative role under the HIPAA legislation (also sponsors SNIP).