Explanations of Medicare Terms

NIH says heart failure means a weak heart. They say an alternate name is congestive heart failure.

NIH says knee or hip arthroplasty (Medicare term) means replacement.

NIH says COPD means emphysema or chronic bronchitis.

NIH says AMI, acute myocardial infarction, means heart attack.

NIH defines comfort care as symptom relief at the end of life, along with mental and spiritual comfort for terminal patients, so when doctors mention comfort care, they do not mean cure.

NIH says palliative care includes many treatments at any stage of illness, but they immediately discuss advance directives, DNR, and refusal of life-sustaining treatment. They also consider palliative care part of the same research field as end of life. While they say palliative care does not mean intent to die or forgo treatment, the message is very mixed, which is why many doctors and HealthGrades ratings of hospitals think it signals less treatment. Often it causes drowsiness, so patients participate less in decisions.

Critical Access Hospitals, designated state by state, are generally rural with less than 25 beds, average stays under 4 days, and 35 miles from other hospitals. (42cfr485.601 to 647). They are marked in our "Combined list" of hospitals, and are identified by "13" in the middle of the hospital Id number. They get extra payments to support better care than small hospitals otherwise could give.

Accountable Care Organizations (ACO) are groups of health providers who get paid more if they lower Medicare costs for the patients they see and meet minimum quality standards, including reducing admissions and readmissions (pp.10-13). Readmissions do not count against them if the patient dies within 30 days of initial discharge, and deaths do not count at all. Patients do not sign up. Medicare tracks which patients get most of their care from the ACO, and then rewards the ACO if Medicare saves money on these patients.