Test Your Health Speak Abilities

Tim Dunbar

September 29, 2011
Legislation and Policy

I’ve been working for CHI for slightly over a year, and I am just beginning to feel comfortable with the Colorado health lexicon.  Full disclosure: I even had a head start – my wife worked as a senior research analyst at CHI for four years.  My handicap is that I am a numbers and operations guy, not a policy analyst. Upon joining CHI, I discovered a dizzying array of new terms. My head swam as I stumbled through acronyms like:

  • ACA
  • ACO
  • ACS
  • ACF
  • AHEC
  • EBNE
  • SBHC
  • FQHC

I also asked my co-workers about foreign terms like:

  • Clawback
  • Crowd out
  • Carve out
  • Reinsurance
  • Stair step

(The answers can be found below.)

Fortunately, I found out that my colleagues are not only masters of these terms, but are shaping the conversations in which these terms are at play. I’ll probably never become a health policy geek, but it is comforting to know that I am surrounded by them. CHI speaks health. We also have a renewed commitment to translating the language. Our analysis is clear, informative and useful. Our publications are timely and accessible. Our staff members are approachable and helpful. Allow us to be your trusted resource.

Confused by a term not listed here? CHI’s HealthWords was prepared to assist policymakers, state and local agency officials and others to better understand the myriad of terms and acronyms that are part of ongoing health policy discussions  in Colorado.

  • ACA – Affordable Care Act
  • ACO – Accountable Care Organization
  • ACS – American Community Survey
  • ACF – Alternative Care Facility
  • AHEC – Area Health Education Center
  • EBNE – Eligible But Not Enrolled
  • SBHC – School Based Health Center
  • FQHC – Federally Qualified Health Clinic
  • Clawback  - The mechanism by which states repay the federal government for prescription drugs that states formerly paid for through Medicaid but which are now paid for by Medicare part D
  • Crowd out – The case in which a new or expanded public health insurance program designed to extend coverage to a previously uninsured population prompts otherwise eligible privately insured individuals to drop their private coverage to take advantage of the public option
  • Carve out – A set of Medicaid services exempted from the capitation rate set for managed care plans.  Also, certain populations such as the aged, blind, or people with disabilities may be “carved out” from mandatory Medicaid managed care plan enrollment
  • Reinsurance – Insurance for insurance companies in which a third party insurer, sometimes the state, assumes responsibility for high-cost, low-frequency claims, thus lowering the average risk of a group and resulting in lower premiums for an insured group
  • Stair step – The situation in which children in the same family are eligible for different public programs, either Medicaid or CHP+, because they have different eligibility standards based on the child’s age in combination with the family’s income.