Glossary
a | b | c | d | e | f | g | h | i | j | l | m | n | o | p | q | r | s | t | u | v | w
Click one of the letters above to be taken to a page of all terms beginning with that letter.
- Magnetic Resonance Imaging
- A noninvasive diagnostic technique based on radio wave-induced nuclear magnetic resonance of atoms within the body. It produces computerized images of internal body tissues.
- Managed care
- Any method of health care delivery designed to reduce unnecessary utilization of services and provide for cost containment while ensuring that high quality care or performance is maintained. Arrangements made by payers to promote cost-effective health care through establishing selective relationships with health care providers, developing coordinated or integrated delivery systems, and conducting medical management activities.
- Managed competition
- As defined by Alain Enthoven, refers to a means to reform the health care system that blends competitive and regulatory strategies. Under managed competition, a sponsor (government, an employer, a purchasing cooperative) on behalf of a large group of subscribers acts as an impartial broker, continually structuring and adjusting the market to overcome attempts by insurers to avoid price competition by segmenting markets or selecting good risks. The sponsor sets rules, sets benefit design, selects participating health plans, manages enrollment, and contracts with health plans. As a purchasing strategy, it obtains maximum value for money by using rules of competition to reward high performing health plans with more subscribers (and thus more revenue).
- Marginal benefit
- In economic analysis, the added advantage generated by the next unit consumed.
- Marginal cost
- In economic analysis, the added expense of producing one additional unit of output.
- Market segmentation
- In economics, the act of classifying an overall market into groups, or segments, that share one or more characteristics (such as age, region of residence, or average health status) that would suggest they would have similar product or service needs.
- Market share
- In health economics, the proportion of the potential market for goods or services within a geographic area held by a supplier of goods or services (e.g., the number of patients admitted to a specific hospital in a geographic area divided by the total number of patients admitted to hospitals in the geographic area).
- Massachusetts Health Reform Law of 2006
- On April 12, 2006, then-Governor Mitt Romney signed into law Chapter 58 of the Acts of 2006, a bill to provide universal health care coverage to citizens of Massachusetts. Among other provisions, the law includes both a mandate to individuals to purchase insurance, a mandate to employers to offer insurance, and expansions of Medicaid/SCHIP.
- MassHealth
- The Medicaid program of the Commonwealth of Massachusetts.
- Means testing
- An investigation to determine a person's eligibility for financial assistance, as for government programs, such as Medicaid.
- Medicaid
- The federal program that provides health care to indigent and medically indigent persons. In contrast to Medicare, which is federally funded and administered at the federal level, Medicaid is partially federally funded and is administered by the states.
- Medicaid expansions
- Policy changes that involve extending state eligibility rules for Medicaid to cover a larger number of individuals (e.g., increasing the minimum income level at which a person becomes eligible).
- Medical Expenditure Panel Survey
- A set of large-scale surveys of individuals and families, their medical providers, and employers across the United States. It is the most complete source of national data on the cost and use of health care and health insurance coverage.
- Medical group
- Any partnership, association, or group of three or more physicians, dentists, psychologists, podiatrists, or other licensed health care providers working together in a medical practice.
- Medical home
- A medical practice arrangement that, in theory, facilitates the delivery of comprehensive care and promotes strong relationships between patients and their primary care team. There is much variability in practice and no widely agreed-upon definition, but some key components include: convenient access to care; care coordination by physician-led practice teams; active patient participation; the use of evidence-based guidelines; and increased use of electronic health records.
- Medical malpractice
- A judicial determination that there has been a negligent failure to adhere to current standards of care, resulting in injury or loss to a patient and legal liability to the responsible provider. A person who alleges medical malpractice must prove four elements: (1) a duty of care; (2) violation of the standard of care; (3) a compensable injury; and (4) causation (that the injury was caused by the substandard conduct).
- Medical malpractice "pressure"
- In a geographic area, the combined effects of a significant number of large damage awards, rising malpractice insurance premiums, contractions in the supply of malpractice insurers, and deterioration in the financial health of malpractice insurers.
- Medical Savings Account
- An early form of tax-advantaged savings account that has been superceded by Health Savings Accounts (HSA).
- Medically Underserved Area/Medically Underserved Population
- Geographic areas or populations designated by the Health Resources and Services Administration (an agency of the U.S. Department of Health and Human Services) as having too few primary care providers, high infant mortality, high poverty and/or high elderly population. The designation is used to determine which areas have priority for assistance.
- Medicare
- A federally administered health insurance program for Americans 65 years of age and older, certain disabled individuals under the age of 65, and those of any age who have end-stage renal disease. Composed of four "parts": A (hospital insurance), B (medical insurance), C (Medicare Advantage plans), and D (prescription drug plans). Medicare does not offer total coverage, and it includes premiums, deductibles, and copays. (See also Medigap).
- Medicare Advantage
- A plan (HMO, PPO, private fee-for-service, and medical savings account) offered by a private insurance company that contracts with the Centers for Medicare & Medicaid Services (CMS) to provide Medicare Part A and B benefits. These plans may cover more services and have lower out-of-pocket costs than original (fee-for-service) Medicare. Some plans also cover prescription drugs. The program was previously called Medicare+Choice and is also sometimes referred to as Medicare Managed Care.
- Medicare Current Beneficiary Survey
- A continuous, multipurpose Centers for Medicare & Medicaid Services (CMS)-sponsored survey of a nationally representative sample of aged, disabled, and institutionalized Medicare beneficiaries. It is the only comprehensive source of information on the health status, health care use and expenditures, health insurance coverage, and socioeconomic and demographic characteristics of the entire spectrum of Medicare beneficiaries.
- Medicare Evidence Development & Coverage Advisory Committee
- An entity established to provide independent guidance and expert advice to supplement the Centers for Medicare & Medicaid Services (CMS)'s internal expertise. The committee reviews, evaluates and makes recommendations to the Centers for Medicare and Medicaid Services (CMS) based on an examination of the strength of data and information on the effectiveness and appropriateness of medical items and services that are covered under Medicare or that may be candidates for coverage under Medicare. Was formerly known as the Medicare Coverage Advisory Committee (MCAC).
- Medicare for All
- S.B. 1218, introduced by Senator Ted Kennedy in April 2007, would amend the Social Security Act to add a new title XXII (Medicare for All) under which each eligible individual would be entitled to health benefits which include the full range and scope of benefits available under the original fee-for-service Medicare program (Parts A and B), subject to appropriate cost sharing, and each enrollee would be free to choose his or her own doctor and private health plan.
- Medicare Health Support Organization
- Section 721 of the Medicare Prescription Drug, Improvement and Modernization Act (MMA), Pub. Law No. 108-173 (2003) created Medicare Health Support (MHS), targeting chronically ill beneficiaries enrolled in original fee-for-service Medicare. MHSOs are paid a monthly per-beneficiary fee for managing a population with congestive heart failure or complex diabetes, or both. The program is designed to require budget neutrality.
- Medicare Inpatient Prospective Payment System
- A system of payment, set forth by Section 1886(d) of the Social Security Act, for the costs of inpatient stays at acute care hospitals under Medicare Part A (Hospital Insurance). Under IPPS, each case is categorized into a diagnosis-related grouping (DRG). Each DRG has a payment weight assigned to it, based on the average resources used to treat Medicare patients in that DRG. Rates are set prospectively.
- Medicare Modernization Act
- The Medicare Prescription Drug, Improvement and Modernization Act (MMA), Pub. Law No. 108-173 (2003) included a number of provisions for overhauling Medicare, most notably introducing a prescription drug benefit for beneficiaries (Part D), and Medicare Advantage to replace Medicare+Choice.
- Medicare Participating Heart Bypass Center Demonstration
- This demonstration, conducted in the early 1990s, tested bundled payment for an episode of care that included all inpatient and physician services during hospitalization, readmissions within 72 hours, and related physician services during the 90-day global period, but not other physician services. The Medicare program saved an average of 10 percent for bypass patients in demonstration hospitals.
- Medicare Payment Advisory Commission
- A commission established by Congress in the Balanced Budget Act of 1997 to replace the Prospective Payment Assessment Commission and the Physician Payment Review Commission. MedPAC is directed to provide Congress with advice and recommendations on policies affecting the Medicare program.
- Medicare Prescription Drug Plan
- An insurance plan that provides prescription drug benefits under Medicare Part D.
- Medicare Private Fee-for-Service
- A type of Medicare Advantage plan that allows an individual to go to any Medicare-approved doctor or hospital that accepts the plan's payment. The insurance plan, rather than the Medicare program, decides how much it will pay and what the patient will pay for services.
- Medicare Prospective Payment System
- A method of reimbursement in which Medicare payment is made based on a predetermined, fixed amount. The payment amount for a particular service is derived based on the classification system (for example, DRGs). The Centers for Medicare & Medicaid Services (CMS) uses separate PPSs for reimbursement to acute inpatient hospitals, home health agencies, hospice, hospital outpatient, inpatient psychiatric facilities, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities. (See also IPPS).
- Medicare+Choice
- See Medicare Advantage
- Medigap (Medigap Supplemental Insurance Policies)
- Health insurance sold by private insurance companies to fill the "gaps" in original fee-for-service Medicare plan coverage. Insurance companies can only sell "standardized" Medigap policies (Medigap Plans A through L) which have different sets of basic and extra benefits.
- Meta-analysis
- A method for combining and integrating the results of independent studies of the effect of a given intervention. The label is used broadly to mean the averaging of results across studies. In a strict sense, it refers to a defined method for acquiring reports of randomized clinical trials, rating and culling these reports for quality of the research, and statistically combining the results of remaining studies.
- MICRA
- see California Medical Injury Compensation Reform Act of 1975
- Microsimulation
- A software-based tool that is used to represent a real-life system via an explicit model to determine how a change in one or more variables affects the rest of the system. This method is widely used when the problem cannot be solved by mathematical analysis, such as linear programming. Simulation provides comparisons of alternative systems or how a particular system works under specified conditions. It is a technique used for "what-if" scenarios.
- Minute Clinic
- see retail clinic
- Misuse
- A preventable complication that occurs when an appropriate service has been selected but the patient does not receive the full potential benefit of the service. The term includes incorrect diagnoses as well as medical errors and other sources of avoidable complications (such as infections that patients acquire during a hospital stay).
- Modeling
- In empirical modeling, relationships between observed phenomena are postulated and interest focuses on simulating and quantifying the cause-and-effect relationships, elasticities, and the like. Critical issues in modeling include making sure that it relates to relevant issues, has an appropriate time horizon, embodies relevant outcomes, makes realistic assumptions, and employs robust mathematical descriptions and appropriate modeling techniques.
- Modifiable risk factors
- Health behaviors, such as smoking or exercise, that can be changed by individuals; in contrast, genetic risk factors cannot be influenced by individual behavior.
- Moral hazard
- The prospect that a person insulated from financial risk by a health insurance policy may behave differently than they would if they were at risk for the costs of their own medical care.
- Mortality ratio
- The number of deaths from a specific cause divided by the expected number of deaths from that cause; it can be used to compare health outcomes between institutions, regions, or nations.
- Myocardial infarction
- see AMI (acute myocardial infarction)