States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019
Acronym Glossary
AAC – Actual Acquisition Cost
ACA – Affordable Care Act
ACO – accountable care organization
ASO – Administrative Services Organization
APCD – all-payer claims database
APM – alternative payment model
BH – behavioral health
CDC – The Centers for Disease Control and Prevention
CFC – Community First Choice
CHIP – Children’s Health Insurance Program
CHIPRA – Children’s Health Insurance Program Reauthorization Act of 2009
CMS – The Centers for Medicare and Medicaid Services
CON – Certificate of Need
CSHCNs – children with special health care needs
DBM – dental benefit manager
D-SNP – Medicare Dual Eligible Special Needs Plans
DSRIP – Delivery System Reform Incentive Program
DUR – drug utilization review
EAC – Estimated Acquisition Cost
ECHO, Project – Extension for Community Healthcare Outcomes
ED – emergency department
EPSDT – Early and Periodic Screening, Diagnostic, and Treatment
FAD – Financial Alignment Demonstration
FDA – Food and Drug Administration
FFS – fee-for-service
FFY – federal fiscal year
FIDE-SNP – Fully Integrated Dual Eligible Special Needs Plans
FPL – federal poverty level
FQHC – federally qualified health center
FY – state fiscal year
GED – general educational development or diploma
HSA – health savings account
HCBS – home and community-based services
HEDIS – Healthcare Effectiveness Data and Information Set
HIT – health information technology
ICF-ID – intermediate care facilities for individuals with intellectual disabilities
I/DD – intellectual and developmental disabilities
IEP – individualized education program
IMD – institutions for mental diseases
LTSS – long-term services and supports
MAGI – modified adjusted gross income
MAT – medication-assisted treatment
MCO – managed care organization
MED – morphine equivalent dose
MFP – Money Follows the Person (federal grant program)
MH – mental health
MLTSS – managed long-term services and supports
MLR – medical loss ratio
MME – morphine milligram equivalent
MMIS – Medicaid Management Information System
NADAC – National Average Drug Acquisition Costs
NCQA – National Committee for Quality Assurance
NEMT – non-emergency medical transportation
NF – nursing facility
OT – occupational therapy
OUD – opioid use disorder
P4P – pay for performance
PA – prior authorization
PACE – Programs of All-Inclusive Care for the Elderly
PCCM – primary care case management
PCMH – patient-centered medical home
PDL – preferred drug list
PDMP – Prescription Drug Monitoring Program
PHP – prepaid health plan
PIP – performance improvement projects
PMPM – per-member per-month
PT – physical therapy
RHC – rural health center
SAMHSA – Substance Abuse and Mental Health Services Administration
SBIRT – Screening, Brief Intervention, and Referral to Treatment
SED – serious emotional disturbance
SIM – State Innovation Models federal grant program
SMI – serious mental illness
SNAP – Supplemental Nutrition Assistance Program
SPA – State Plan Amendment
SSI – supplemental security income
SUD – substance use disorder
TPL – third party liability
VBP – value-based purchasing
WIC – Special Supplemental Nutrition Program for Women, Infants, and Children