A

Glossary

Accountable Care Organizations (ACOs): The Centers for Medicare & Medicaid Services defines ACOs as groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients. ACOs have come to hold an even broader meaning, referring to coordinating activities for health care and health for patients of all kinds (e.g., not just Medicare) and for communities in general, as described by the related concepts of Accountable Care Communities and Accountable Health Communities (Austen BioInnovation Institute, 2012; Magnan et al., 2012).

Healthy conditions: The committee used this term in reference to the Department of Health and Human Services (HHS) definition of quality in public health reference to “conditions in which people can be healthy,” denoting the determinants of health or factors influencing health. These also correspond to intermediate outcomes.

Healthy People 2020: An effort of HHS, Healthy People “provides science-based, 10-year national objectives for improving the health of all Americans. For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to: encourage collaborations across communities and sectors, empower individuals toward making informed health decisions, and measure the impact of prevention activities.”1

Leading Health Indicators (LHIs): Twenty-six metrics organized by 12 topics that represent a key set in Healthy People 2020, drawn from the more than 1,200 Healthy People 2020 objectives.

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1 See http://www.healthypeople.gov/2020/about/default.aspx (accessed June 13, 2013).



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A Glossary Accountable Care Organizations (ACOs): The Centers for Medicare & Medicaid Services defines ACOs as groups of doctors, hospitals, and other health care providers, who come together voluntarily to give co- ordinated high-quality care to their Medicare patients. ACOs have come to hold an even broader meaning, referring to coordinating activities for health care and health for patients of all kinds (e.g., not just Medicare) and for communities in general, as described by the related concepts of Accountable Care Communities and Accountable Health Communities (Austen BioInnovation Institute, 2012; Magnan et al., 2012). Healthy conditions: The committee used this term in reference to the Department of Health and Human Services (HHS) definition of quali- ty in public health reference to “conditions in which people can be healthy,” denoting the determinants of health or factors influencing health. These also correspond to intermediate outcomes. Healthy People 2020: An effort of HHS, Healthy People “provides science-based, 10-year national objectives for improving the health of all Americans. For 3 decades, Healthy People has established bench- marks and monitored progress over time in order to: encourage collabo- rations across communities and sectors, empower individuals toward making informed health decisions, and measure the impact of prevention activities.”1 Leading Health Indicators (LHIs): Twenty-six metrics organized by 12 topics that represent a key set in Healthy People 2020, drawn from the more than 1,200 Healthy People 2020 objectives. 1 See http://www.healthypeople.gov/2020/about/default.aspx (accessed June 13, 2013). 95

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96 TOWARD QUALITY MEASURES FOR POPULATION HEALTH Multisectoral health system: Refers to the array of sectors and entities that influence the health of the population through their activities, ideally in a coordinated manner, as a system, but in practice, operating through occasional and not always sustained collaboration. The system comprises public health agencies, health care delivery organizations, and parts of other sectors (e.g., businesses, schools) and the community (IOM, 2011a). After introducing the term, the report often shortens it to “health system.” National Priorities Partnership: At the behest of HHS, the National Quality Forum (NQF) convened more than 50 public and private organi- zations in the National Priorities Partnership, which provides annual in- put to HHS on the implementation of the National Quality Strategy. National Quality Forum (NQF): The Forum is a nonprofit membership organization that “operates under a three-part mission to improve the quality of American health care by  building consensus on national priorities and goals for perfor- mance improvement and working in partnership to achieve them;  endorsing national consensus standards for measuring and pub- licly reporting on performance; and  promoting the attainment of national goals through education and outreach programs.”2 National Quality Strategy: In 2010, the Affordable Care Act charged HHS with developing a national quality strategy to “improve the delivery of health care services, patient health outcomes, and population health. After engaging both public and private stakeholders and collecting input, the National Quality Strategy was released in March 2011.”3 The nine aims or the nine characteristics: see Quality characteristics Population health: The health of the public in a geopolitical location; see also Total population health 2 See http://www.qualityforum.org/About_NQF/About_NQF.aspx (accessed June 27, 2013). 3 Healthcare.gov factsheet: http://www.healthcare.gov/news/factsheets/2012/04/national- quality-strategy04302012a.html (accessed June 27, 2013).

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APPENDIX A 97 Public health: In the report, this term refers to governmental public health agencies, also known as health departments, and to their work (public health practice and public health activities). Public health quality: “The degree to which policies, programs, ser- vices, and research for the population increase desired health outcomes and conditions in which the population can be healthy” (Public Health Quality Forum, 2008). Quality characteristics: Shorthand for the nine aims for improvement of quality in public health or characteristics to guide public health prac- tices (Public Health Quality Forum, 2008). Six drivers: The six priorities for quality improvement in public health (Honoré and Scott, 2010). Three-Part Aim: The Three-Part Aim is the HHS adaptation of the Institute for Healthcare Improvement’s “Triple Aim,” and is a conceptual triad of (1) better care, (2) lower cost, and (3) healthy people/healthy communities; see also Triple Aim Total population health: A term developed to distinguish the public health profession’s understanding of population health from the narrower interpretation of population health used in the health care delivery sector. Total population health refers to the population in a geopolitical area, while the term “subpopulations” can be used to describe the populations of patients or insured individuals to which practitioners in health care delivery refer. Triple Aim: Improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of care.4 4 See http://www.ihi.org/offerings/Initiatives/TripleAim/Pages/default.aspx (accessed June 13, 2013).

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