Vital Signs

An eligible clinician is a practitioner who may take part in, or must take part in, a Medicare payment incentive or quality reporting program. This post explains the HIMSS Dictionary entry and the difference between an eligible clinician and a MIPS eligible clinician under federal regulations, then reviews three studies of MIPS participation, payment, and documentation burden.

Activity-based costing assigns costs to the activities that cause them rather than to departments. This post explains the HIMSS Dictionary definition, then reviews five sources: a systematic review of cost measurement in value-based health care that found 215 studies, a breast cancer study that used location-system data to cost care at multiple sites, a cornea surgery analysis of 559 procedures built on EHR data, a pharmacy costing model for diabetes care, and a review of the basic steps of time-driven costing.

A relative value unit (RVU) is a comparable measure of the resources needed to perform services, based on factors such as personnel time, skill level, and equipment, and it is widely used in productivity-based pay. This post explains the HIMSS Dictionary definition, then reviews five 2026 sources: a national emergency physician group that found no significant effect from moving to RVU pay across 167 departments, a policy analysis on measuring workload in value-based care, a radiology study in which 31 and 33 percent of sampled studies had mismatched image counts, an ethics article, and a primer for surgeons.

An outcome measure is a yardstick for judging what an activity, program, system, treatment, or process achieved, set against what was planned. This post explains the HIMSS Dictionary definition, then reviews six sources: a standard outcome set for multiple sclerosis, a core outcome set for pediatric maintenance fluid therapy with 47 authors, a pharmacy outcome measure ranking, a scoping review of PROMIS in routine care, a systematic review of PROMs inside the EHR, and a nine-clinic study of the IT barriers to electronic PROMs.

The Value Modifier was a Medicare adjustment, applied on a per-claim basis to payments under the Physician Fee Schedule and set at the Taxpayer Identification Number level, that rewarded quality performance and lower costs. This post explains the HIMSS Dictionary definition, then reviews five sources: the 2015 law that ended the separate modifier and carried its measures into MIPS, a study of length of stay risk adjustment, a cross-specialty analysis of 558,296 clinicians in the 2018 MIPS, a study of how practice characteristics related to 2019 MIPS scores, and a framework for an emergency medicine MIPS Value Pathway.

Integrated care is the systematic coordination of general and behavioral health care, bringing mental health, substance use, and primary care services together for people with multiple needs. This post explains the HIMSS Dictionary definition and what integration requires from health IT, then reviews four sources: a systematic review of 21 real-world collaborative care programs, a narrative review of collaborative care for depression in chronic illness, a cluster randomized trial across 22 primary care practices that used EHR decision support, and a clinician study of mHealth in integrated primary care.

A qualified clinical data registry, or QCDR, is an entity that gathers clinical data from MIPS clinicians, individually or in groups, and reports it to CMS for them. Unlike a qualified registry, it is not limited to measures in the Quality Payment Program. This post explains the HIMSS Dictionary definition, then reviews four sources: an interrupted time series of 85 rheumatology practices that joined a QCDR, a study of dashboard engagement across 211 practices, a review of quality measure availability by specialty, and an analysis of topped-out MIPS measures.

Care management is a set of activities that ensures each person served has a single approved care plan that is coordinated, not duplicative, and designed for cost-effective care and good outcomes. This post explains the HIMSS Dictionary definition and reviews four sources: the Camden Coalition randomized trial, a CareMore randomized trial of complex care management for Medicaid patients, a nurse-led program for multimorbidity, and a trial in a community health center.

In the HIMSS Dictionary, LAN has more than one meaning; this post covers the Health Care Payment Learning and Action Network, launched in March 2015 through CMS to move health care away from volume-based fee-for-service payment. It explains how the network’s framework of alternative payment models is used and reviews five sources: a 2026 proposal that applies the framework to collaborative behavioral health care, an oral health payment framework with 4 categories and 9 mechanisms, a commentary on Medicare advanced APMs, a review of APMs and diabetes outcomes, and a five-level value-based payment maturity model.

An ACG, in the HIMSS Dictionary an Ambulatory Care Group and also known as an Adjusted Clinical Group, is a method of grouping outpatient episodes by expected use of resources, modified by principal diagnosis, age, and sex. This post explains the term and reviews six studies: an Ontario analysis of 11.4 million adults in 60 ACG levels, a comparison of comorbidity scales in 3,496 older adults, a Veneto region cost model, a hospital-only application in Singapore, a Norwegian validity study of 168,285 adults, and a 2026 test of machine learning on ACG features.

An integrated delivery network, or IDN, is a formal system of providers and sites of care that delivers health care services and also offers a health insurance plan to patients in a geographic area. This post explains the structure and why it matters for health IT, then reviews four studies: how centralized IT governance related to technology adoption across 485 systems, the total cost of robotic surgery across 14,315 procedures, lung cancer screening completion across 51 primary care clinics, and a pharmacy workflow system rolled out in three hospitals.

DSRIP, the Delivery System Reform Incentive Payment program, is a Medicaid delivery system reform program that gives states funding to help hospitals and other providers change how they deliver care to Medicaid beneficiaries. This post explains the idea and reviews what four studies found: New Jersey claims data on asthma and readmissions, a California safety analysis, a safety-net hospital infection and sepsis initiative, and a protocol for studying new Massachusetts Medicaid ACOs.

The Chronic Care Model, developed by Edward Wagner and colleagues, is a framework with six dimensions that helps health care teams care for people with long-term conditions. This post explains the six dimensions and the role of clinical information systems, what a 2026 meta-analysis found about collaborative chronic care models for bipolar disorder, what a study of 470 accountable care organizations found about health IT and unplanned admissions, and how information technology supports care coordination.

Chronic care management (CCM) is a Medicare service for patients with two or more chronic conditions that pays for care coordination outside face-to-face visits, supported by an electronic comprehensive care plan, 24/7 access, and managed transitions. This post explains the CMS requirements, how complex CCM and newer bundles such as advanced primary care management differ, and what studies found about pharmacist-led CCM revenue, a 26,500-patient platform, and team-based remote monitoring.

The Quality Payment Program (QPP) is the CMS program created under MACRA that adjusts Medicare payments to clinicians through two tracks, the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models. This post explains the four MIPS performance categories, the performance threshold and 9 percent adjustment in 42 CFR 414.1405, and what two studies found about how payment adjustments differ by reporting pathway.

An Advanced APM is a Medicare payment model that qualifies clinicians for the Advanced APM track of the Quality Payment Program, which requires certified EHR technology, payment tied to quality measures, and more than nominal financial risk. This post explains the criteria in 42 CFR 414.1415, the QP thresholds, how the APM incentive fell from 5 percent to 1.88 percent, and what studies found about ACO clinicians.

A medical home is a model of primary care meant to be easy to reach, ongoing, broad in scope, family-centered, coordinated, caring, and responsive to culture, with the primary care team coordinating all of a patient’s care. This post explains what the evidence shows from a claims study of 5,943 practices, a cluster randomized trial, and a systematic review in diabetes, and why implementation details and electronic communication matter.

Quality measures are tools that express the quality of care as a number by comparing performance with a criterion. This post explains how process, outcome, and patient-reported measures differ, what an electronic diagnostic measure for pneumonia and a review of patient-reported outcome measures in payment models found, and why documentation and data quality decide whether a measure is fair.

An episode of care is a group of services given for a specific medical problem over a set time period. This post explains how episodes are defined, how Medicare’s CJR and TEAM bundled payment models use them, what a systematic review of CJR found for spending and outcomes, and what clinical and data teams must do to support episode-based care.

OASIS is a standardized set of assessment items collected for adult home health patients and used to measure outcomes and quality. This post explains the Medicare conditions of participation that govern it, the current OASIS-E1 and OASIS-E2 versions, what a recent national analysis found about linking OASIS to claims, and how home health nurses and informaticists protect data accuracy.