To answer your writing and editing questions, consult these resources in this order, as appropriate:
- This style sheet
- Almanac style sheet
- Guidelines for Submission of Publication Drafts
- Chicago Manual of Style, 17th ed. (Numbers in parentheses link to CMOS Online.)
- Merriam-Webster Collegiate Dictionary, 11th ed. (herein M-W)
- The Indigo Book, for legal citations
Table of Contents
Abbreviations, Acronyms, Initialisms | Academic Degrees | Ages | Almanacs | Asset-Framing | Authorship
Bias-Free and Person-First Language
Capitalization | Citations and References | Composition Titles
Footnotes | Fractions
Illustrations (charts, figures, tables) and Appendices | Internet, Web
Names | Numbers
Page Numbers, Chapters, and the Like | Percentages | Places | Punctuation and Spacing
Race/Ethnicity | Rankings
Spelling and Vocabulary
0–9, A B Ca–Cl Coa–Com Con–Cu DE F G H IJ KL M–Mh Mi–N O P–Pl Po–Pu QR S TUV WXYZ
Abbreviations, Acronyms, Initialisms
If a term or an organization’s name will be used more than once, spell it out the first time, followed by its abbreviation in parentheses. Afterward, use the abbreviation (10.3, 10.24, 10.26) in text and heads.
I work at the California Health Care Foundation (CHCF). The headquarters of CHCF are in Oakland.
But treat an executive summary or a sidebar as an independent document for purposes of abbreviations.
Rewrite to avoid making an initialism possessive, but if a term is introduced in the plural, write its abbreviation in the plural too: Health Maintenance Organizations (HMOs).
See also Academic Degrees, Company Names, Names.
Omit internal punctuation (10.20) with academic degrees (MD, MS, PhD, RN) and generally do not use other credentials (CMT, FACP, etc.) unless important to topic of report.
Hyphenate an age as a noun or adjective (7.89, 5.250).
an eight-year-old boy
6- to 12-year-old kids
people age 65 (not aged)
65 or older
five years old
age 65+ or >65 (acceptable in graphics)
The CHCF Health Care Almanac is made up of two kinds of products. The first is a series of graphic publications that provide data and analysis on aspects of the health care market, such as costs, disparities, providers, quality of care, and insurance. These are data-heavy chartbooks. The second are market reports focused on particular regions in California that also contain data and analysis.
All Almanac products, and data snapshots not part of the Almanac series, should follow the Almanac style sheet.
In writing about an individual or group of people, apply an asset-framing approach. Asset-framing is a narrative model that defines people by their assets and aspirations before noting the challenges and deficits. This model invests in people for their continued benefit to society. Learn more about asset-framing and how CHCF is adopting this model (PDF).
On the title page, list only names, degrees (Madelyn Walters, MS, MPH), and organization.
In the “About the Author” section, list names, appropriate degrees, title, and organization:
Al Malamute, PhD, MD, director of surgery, Stanford University Hospital
Any brief, factual description (up to 50 words) should not be promotional in tone.
Bias-Free and Person-First Language
To avoid gender bias, use these strategies (5.252):
- If possible, rewrite to avoid him and her, or recast in the plural: a doctor must wash his hands often becomes doctors must wash their hands often.
- Use nonsexist words instead of “man” words: people not mankind, chair not chairman.
Put the person first to avoid marginalizing and dehumanizing when writing about someone’s chronic illness, disability, economic circumstances, or other traits. Putting the person first prioritizes the person as a human being and does not define or categorize people by condition, circumstance, or trait.
For example, use:
- People who are homeless or people experiencing homelessness, not the homeless or homeless people
- Californians with low incomes, not low-income Californians
- Children of families with low incomes, not low-income children
It is acceptable to precede a noun with “low-income” and the like writing about a region or population being defined by that characteristic, and when the phrase cannot be easily recast to put people first; for example:
- The study found that people in low-income communities (defined as more than 50% of the population with incomes below 200% of the federal poverty level) experience higher rates of chronic illness than the general population.
- Community health centers and independent physician practices that predominantly serve low-income communities are eligible to apply.
When referring to someone with a disease, emphasize the person, not the disease (5.260): a patient with diabetes (preferred) or a diabetic patient. Never employ as a noun: diabetics, schizophrenics, or the like.
Capitalize generic terms as part of proper names, but lowercase them in references (8.51, 8.66, 8.68): California Health Care Foundation, the foundation; the Department of Disease Eradication, the department; Stanford University, the university. But see Places.
Names of companies or brands that start with a lowercase letter followed by a capital (eConsult) don’t need to be capped when they start a sentence, although some editors may want to reword (8.154).
Lowercase the names of seasons in running text (8.88) but cap them in journal issue dates (see Citations and References).
Use these guidelines for headings and the titles of books, journals, articles, podcasts, etc. (8.159).
- Always capitalize the first and last words of a title and subtitle, and capitalize all other major words, including nouns, pronouns, verbs, adjectives, adverbs, and some conjunctions, except as noted below.
- Lowercase articles: a, an, the.
- Lowercase prepositions of four or fewer letters: for, in, of, on, with but Above, Between, Through, Within.
- Lowercase the conjunctions and, but, for, nor, or.
- Lowercase to as a preposition and as an infinitive (to Examine); lowercase as.
- For hyphenated words (8.161), capitalize both elements: Follow-Up Report.
Citations and References
Table of Contents
- General format (Authors; Titles; Links; Publishers; Dates; Pages, illustrations, tables; Repeated sources; Multiple sources)
- Blog posts or magazine or newspaper articles
- Cochrane database articles
- Data requests
- Journal articles
- Lectures or papers presented at a conference
- Legal and Legislative
- Press releases
- Reports, brochures, pamphlets
For citations, use endnotes, not footnotes (except in Almanacs and when necessary in sidebars). Use Microsoft Word’s Reference feature, which handles note numbering automatically.
All endnote numbers in the text should be superscripted (14.24) and usually follow the sentence’s final punctuation (14.26).
Whenever possible, link to a landing page for a source and not directly to a PDF or other file. But if there are many files linked from the landing page, link directly to the file.
Use this general format for endnotes (see below for details and examples):
[author(s)], [title], [publisher], [date].
For up to three authors, list each, first names first, in the order they are found at the source: Luci Garcia, Karly Menheim, and Abigail Lu.
For four or more, list the first author and add “et al.” (note that only al. takes a period and there’s no intervening comma): Peri Alahar et al.
Only people are authors, not organizations, so do not begin a citation with an org name. If no authors are specified, begin the endnote with the title (14.79).
Use italics for the titles of reports and landing pages (generally, pages that host a report with the same title), journals (14.170), newspapers (14.193), blogs (14.206), books (14.86), and podcasts (14.267): New York Times, JAMA, The CHCF Blog, Radiolab.
Use roman type and quotation marks for journal (14.169) and newspaper articles (14.191), blog posts (14.206), podcast episodes (14.267), and web pages: “Medi-Cal Enrollment Rose 14%.”
Do not use italics or quotations marks for the names of websites (14.206): Google Maps.
Link the title of the first instance of a cited work (omit links in subsequent references to the same source).
Use Digital Object Identifiers (DOIs) whenever available (14.8), mostly for some journal articles. In endnotes, link the title using this format: https://doi.org/[DOI] (https://doi.org/10.1109/5.771073). See below for examples.
For help with legal citations, consult The Indigo Book.
For our purposes, the organization whose website hosts the link is the publisher.
In decreasing order of preference, specify one of these dates:
- Date of publication
- Date the pub or web page was last updated, modified, etc.
- Date the web page was accessed by the author
Pages, illustrations, tables
When citing a page, illustration, or table within a document, specify it at the end (14.158): Medi-Cal Enrollment by State, DHCS, September 2018, 163, table 34B.
Citations to sources already cited use a shortened form (14.29). Avoid ibid and use the shortened form instead (14.34).
The numbered endnote examples below are primary and subsequent citations of the same source. Consult Chapter 14 of CMOS for detailed coverage and extensive examples, and the Chicago-Style Citation Quick Guide and 14.23 for brief examples.
Do not use multiple endnote numbers.1,2 Instead, use one endnote number, and in the endnote separate multiple sources with semicolons, including and before the final source:1
- Dan Forth, How Doctors Treat: A Survey (New York: Knopf, 1967), 48–52; and Jordan Futon, “Health Care in Rural Japan,” Asian Health 24, no. 3 (March 2011): 324.
Blog posts or magazine or newspaper articles (14.205–8)
- Robert Pear, “Cheaper Health Plans Promoted by Trump Have a History of Fraud,” New York Times, October 21, 2017.
- Pear, “Cheaper Health Plans.”
One, two, or three authors
- Dan Forth, How Doctors Treat: A Survey (New York: Knopf, 1967), 48–52.
- Forth, How Doctors Treat, 87.
- Ann Garth, Lee Woods, and Fred Smith, Nurse Reference, 2nd ed. (Stamford, CT: NPC, 2009), 241–302.
- Garth, Woods, and Smith, Nurse Reference, 122.
Four or more authors
- Faye Dunn et al., Therapist Field Guide (Waco, TX: Freud & Sons, 2000), 64–68.
- Dunn et al., Therapist Field Guide, 65.
Cochrane database articles
- Mia Schmidt-Hansen et al., “Buprenorphine for Treating Cancer Pain,” Cochrane Database Systematic Reviews 3 (2015).
- Schmidt-Hansen et al., “Buprenorphine.”
For special data requests by the author.
- Custom data request, Dept. of Health Care Services, received August 16, 2017.
Journal articles (14.164–187)
Capitalize seasons that identify journal issues (14.171): Health Journal 14, no. 2 (Autumn 2017): 45–49.
- Eva H. DuGoff et al., “Multiple Chronic Conditions and Life Expectancy: A Life Table Analysis,” Medical Care 52, no. 8 (Aug. 2014): 688–94.
- DuGoff et al., “Multiple Chronic Conditions.”
Lectures or papers presented at a conference (14.217)
- Frances Isbell et al., “Beyond the Emergency of Homelessness: The Roles of HCH Programs in Planning for and Responding Strategically to Disasters and Emergencies” (PDF) (2018 National Health Care for the Homeless Conference and Policy Symposium, Minneapolis, Minnesota, May 15–18, 2018).
- Isbell et al., “Beyond the Emergency.”
- Vanda Chand, “Medi-Cal in 2030” (MCP Annual Conference, May 5, 2021, virtual).
- Chand, “Medi-Cal.”
Legal (14.269) and Legislative
Bills or resolutions (14.283)
- Safe and Accurate Food Labeling Act of 2015, H.R. 1599, 114th Cong. (2015).
Court cases (14.277, 14.278, 14.279)
- Obergefell v. Hodges, 135 S. Ct. 2584 (2015). [US Supreme Court]
- Olmstead v. L.C., 527 U.S. 581 (1999). [lower federal court]
- Williams v. Davis, 27 Cal. 2d 746 (1946). [Cal. state court]
Federal Register (14.289)
Specify volume, page number, and publication date.
- 58 Fed. Reg. 29422 (May 20, 1993).
Laws or statutes (14.282)
- Patient Protection and Affordable Care Act of 2010 (PDF), Pub. L. No. 111-148, § 2404, 124 Stat. 119 (2010).
- Sarah Brooks (chief, Managed Care Quality and Monitoring Div., DHCS) to all Medi-Cal managed care plans, All Plan Letter 15-008 (PDF), April 16, 2015.
- Centers for Medicare & Medicaid Services (CMS), “Medicare Part D Overutilization Monitoring System (OMS) Summary,” press release, November 3, 2015.
- CMS, “Medicare Part D.”
Reports, brochures, pamphlets (14.220)
When a report is based on annual data (e.g., from government agencies), add the year(s) that the data are from in parentheses, in roman text, after the report title: (2017), (2013 and 2017), (2013–18). Also add the publication date, if available, in the usual place, after the publisher (see the first two examples under Online below). If multiple data years are specified, then for compactness, omit publication years.
- Chuck Babbage, Electronic Health Records (London: Analytical Press, 2000).
- Babbage, Electronic Health Records.
Online (no, one, two, three, and four+ authors)
- Behavioral Health Barometer: California, Volume 5: Indicators as Measured Through the 2017 National Survey on Drug Use and Health and the National Survey of Substance Abuse Treatment Services (PDF), Substance Abuse and Mental Health Services Administration (SAMHSA), 2019.
- Behavioral Health Barometer, SAMHSA.
- Padma Nagappan, How San Diego Is Protecting Its Homeless Population from COVID-19, California Health Care Foundation (CHCF), June 2020.
- Nagappan, How San Diego, CHCF.
- Priti Khanal and Kathy Moses, “How Destination Home Is Partnering with Santa Clara County to Care for Individuals Experiencing Homelessness Amid COVID-19,” Center for Health Care Strategies (CHCS), June 10, 2020.
- Khanal and Moses, “How Destination Home.”
- Mila Kofman, Eliza Bangit, and Kevin Lucia, MEWAs: The Threat of Plan Insolvency and Other Challenges (PDF), Commonwealth Fund, March 2004.
- Kofman, Bangit, and Lucia, MEWAs.
- Prashila Dullabh et al., Evaluation of the State HIE Cooperative Agreement Program: Final Report (PDF), NORC, March 2016.
- Dullabh et al., Evaluation.
Use these guidelines for the titles of reports, books, articles, websites, etc.
Initial the: An initial the in the title of a newspaper or periodical is usually lowercased (unless it begins a sentence) and not italicized (8.170): the New York Times. But for clarity, capitalize and italicize it if otherwise the title would be a single word: The Guardian.
Subtitles: Use a colon to separate a subtitle from a title (8.164): The Avocado Diet: Lose Weight and Help California’s Economy.
Reports, journals, newspapers, and other large works
Italicize, and do not use quotations marks for, the titles of works that are not parts of a larger work — reports, white papers, blogs (not blog posts), books, journals, magazines, newsletters, newspapers, movies, and TV shows (8.163, 8.192): San Francisco Chronicle, Journal of Oncology, Health Affairs.
Journal articles, blog posts, lectures, webinars, and other small works
Do not italicize, but use quotation marks for, titles that are parts of a larger work — journal articles, blog posts, newspaper and magazine articles, lectures at a conference, webinars, and the like (8.163, 8.177, 8.192): “Medi-Cal Funding Increased.”
Websites, surveys, webinar series, and databases
Capitalize, but do not italicize or surround with quotation marks (8.191):
This year, Google is expected to serve up a bazillion page views.
Exception: If the website is primarily a news site or blog, italicize the name (8.192): The Atlantic (cap and italicize The only for two-word names), Buzzfeed, California Healthline, California Health Report, CalMatters, Healthcare Dive, the Huffington Post, Modern Healthcare, Politico, Slate, Stat, The CHCF Blog, Vox. But news services and call letters are not italicized: Associated Press, Kaiser Health News, KQED, ProPublica, Reuters.
Surround the title of a web page with quotation marks (8.191):
Visit “2014 Postpartum Depression Survey Data” for more details.
See also Capitalization.
- Capitalize and spell out months in running text. In tables, notes, and the like, use three-letter abbreviations with periods (10.39): (November, Nov.).
- If no date is specified, do not use a comma after the month (6.38): March 2001.
- If a date is specified, use commas after both the date and the year (6.38): On April 2, 2001, the nurses met.
- Use cardinal numerals (9.31): June 30 not June 30th.
- Centuries: Spell out and hyphenate (9.32): the twenty-first century.
- Use apostrophes only to indicate missing numbers (9.33): the 1800s, the ’70s, the 1970s not the 70’s and not the 1970’s.
- For fiscal years, use FY and a space (nonbreaking, if possible) and an en dash for a range (9.64): FY 2016, FY 2020–21.
When explanatory footnotes are required, use these symbols, superscripted, in this order (14.49) (tip: copy and paste these characters from here): * (asterisk), † (dagger), ‡ (double dagger). If more footnotes are needed, double the symbols: **, ††, ‡‡.
Spell out and hyphenate simple fractions as nouns, adjectives, and adverbs (9.14).
four-fifths of the doctors
a two-thirds majority
one and three-quarters
Singular subjects take singular verbs (one in four counties is rural; more than one in five participants is unmarried; two-thirds of the public says so); plural subjects take plural verbs (one-fourth of respondents say yes). With that or who, use a plural verb: California is one of five states that do fund GME programs.
Capitalize the full names of legislative and administrative bodies, bureaus, centers, departments, and offices (8.62), including US or California, where appropriate.
US Census Bureau
US Department of Health and Human Services
Departments of Defense and Veterans Affairs
Centers for Disease Control and Prevention
Centers for Medicare & Medicaid Services
Health Resources and Services Administration (HRSA)
the House, the Senate
California Department of Finance (DOF)
California Department of Health Care Services (DHCS, poss.: DHCS’s)
California Department of Managed Health Care (DMHC)
California Health and Human Services Agency (CalHHS)
California Office of Health Information Integrity (CalOHII)
California State Assembly
Office of the Patient Advocate (OPA)
Department of Health Care Access and Information (HCAI) (until 10/2021, Office of Statewide Health Planning and Development)
San Francisco Board of Supervisors
Adjectives derived from such terms and paraphrased references to them are usually not capitalized (8.62).
congressional but Congress
city council member
Lowercase certain generic governmental terms (8.65): administration, city hall, federal.
Lowercase state when used generically: the state of California but Washington State.
Apply Word’s built-in styles to headings (Heading 1, Heading 2, etc.). If you want to change the look of, for example Level 1 headings, change the Heading 1 style, not all the individual headings.
Style run-in headings like boldface sentences, using an initial capital letter, boldface, and a period (1.56):
Common DSA shared across all partners. In many communities . . .
Consult the spelling list herein, then CMOS 7.81–7.89, and then M-W.
Illustrations (charts, figures, tables) and Appendices
All illustrations require a title above and a source notation below that includes the year. For flexibility, titles and sources are embedded into the HTML of the page and not embedded into the graphic itself.
In tables, use these conventions:
- Not applicable (measure doesn’t apply): leave blank
- No data (measure applies but data unavailable): — (em dash) (Tip: copy and paste the dash from here.)
- Zero: 0
If a dash is used, add this note: Where a dash appears, no data were available.
Illustrations should be numbered continuously. Tables are numbered separately from other figures such as graphs and illustrations (Table 1, Table 2, Figure 1, Table 3, Figure 2). Appendices are lettered (Appendix A, Appendix B). A table or figure within an appendix includes the appendix’s letter (3.11) (Table A1, Figure B1).
Notes for illustrations belong below the illustration and not in the endnotes. Illustration notes use these symbols in this order (3.79) (tip: copy and paste these characters from here): * (asterisk), † (dagger), ‡ (double dagger), § (section symbol), ∥ (parallels), # (number sign). If more are needed, use double marks in the same order: **, ††, ‡‡, §§, ∥∥, ##.
Figure and table numbers, and appendix letters, are separated from titles by periods. Use title case. Use terminal punctuation if at least most illustration titles in a document are full sentences.
Figure 1. Care Connection Team
Table 2. Current Rural Palliative Care Pilots in California
Appendix B. Emerging Community-Based Palliative Care Models in Rural California
See also Citations and References and Page Numbers, Chapters, and the Like.
Leave URLs intact. In production, they may be condensed.
Proper nouns spelled with an initial lowercase letter followed by a capital needn’t be capitalized at the beginning of a sentence or a heading (8.154).
iPads are growing more popular in hospitals.
eHealth sells thousands of items.
Capitalize a job title when it precedes a name: Vice President Barnes, Professor Gomez.
Normally, lowercase a job title after a name or when used alone (8.19, 8.22, 8.27).
Jed Beam, president; the president
Jesus Gomez, dean of students; the dean
Governor Newsom; the governor but California governor Newsom (8.21)
Assemblymember Julio Jimenez; the assemblymember
Kim Chou, director of funding; the director
Use parallel construction for list items, whether in running text or as bulleted or vertical lists — all nouns or all verbs (6.127).
internists, general practitioners, and physician assistants
greet the patient, consult the chart, wash your hands, and examine the patient
Use the serial comma before the conjunction in a list of three or more items (6.19). If any item has internal punctuation, separate the items with semicolons (6.60).
The administrator ordered cotton balls, gloves, and x-ray film.
The administrator ordered cotton balls; small, medium, and large gloves; and x-ray film.
A list is best introduced by a complete grammatical sentence, followed by a colon (6.130).
Use closing punctuation only if the items are complete sentences (6.130).
In a numbered list, follow each numeral with a period and a capital letter (6.130).
Order these supplies weekly:
Every morning, perform these steps:
1. Boot your computer.
2. Log in.
3. Check your email.
Use the currency symbol and numerals (9.24): $21.09, $3 million.
Use the full name, including ampersands and abbreviations, but you usually may omit Inc., & Co., LLC, and the like (10.23): Merck not Merck & Co. Inc. If the context requires such specificity, omit any preceding comma (6.44): WeCare Health Plan Inc.
Use periods and a space between initials (A. B. Cooper) but omit periods and spaces in names replaced by initials (10.12): JFK.
On first reference, use the person’s first and last names. In subsequent references, use only the last name: Jan Jackson then Jackson; Mortimer Brown, MD, then Brown [not Dr. Brown].
Spelling out versus using numerals:
- For decimal numbers, use numerals (2.5, 4.1 million).
- For whole numbers:
- Spell out one through nine (nine patients, three million members).
- Use numerals for 10 and up (200,000, 11 million).
Exceptions to the general rule:
- At the beginning of a sentence — unless it’s bulleted — either spell out a number or reword the sentence (9.5):
Eighty-six respondents answered every question.
Every question was answered by 86 respondents.
- 86 respondents answered every question.
- When a cluster of numbers near one another all refer to the same thing, and any of the numbers are 10 or more, use numerals for all the numbers (9.7): 3 in 14 enrollees in the southern part of the state, and 5 in 11 in the northern part.
- In describing dosing, use numerals and spell out to: Take 1 pill every 3 to 4 hours.
Use commas for numbers of four digits or more except page numbers, addresses, and years (9.54): 1,541 therapists agree but 23502 Cleaver Avenue.
Use spaces around equal signs, arithmetic operators, and the like (12.16): Adjusted patient days = total gross patient revenue / gross inpatient revenue x number of patient days.
In graphs and charts, use symbols to denote “less than,” “through,” “and above,” and the like: <18, 18–25, 26+.
Use an italicized capital N to represent population size, an italicized lowercase n to represent subpopulation size (3.85).
Californians with cancer (N = 15,578)
Lung cancer diagnoses (n = 4,137)
Central Coast (n = 338)
To represent significance level, use an italicized p and no leading zero (3.78): (p <= .05).
The one in construction takes a singular verb because one is the subject (one in four counties is rural; more than one in five participants is unmarried).
The one of … that/which/who construction takes a plural verb because that or which is the subject (one of eight states that don’t dedicate funding, one of the specialists who accept Medi-Cal).
See also Ages, Dates, Fractions, Money, Percentages, Rankings, Time.
Page Numbers, Chapters, and the Like
Spell out and uppercase references to parts of a document, tables, figures, charts, appendices, and the like: Chapter 9, Section 2.38, Table 2, Figure 4, Appendix B. But lowercase references to pages: page 26.
Use numerals, except at the beginning of a sentence (unless it’s bulleted), and don’t hyphenate even in adjectival form. Use the percent symbol (%) throughout except at the beginning of a sentence (9.18); use less and more as modifiers.
Less than 35.6% responded.
Twenty-six percent of patients agreed.
The proportion of patients agreeing was 26%.
- 26% of patients agreed.
Use a singular verb if the noun is collective (40% of the electorate is Latinx); use a plural verb if the noun is an ordinary plural (15% of participants are women).
In running text, spell out the names of states and of the country (10.27): California, United States (or US). In bibliographies, addresses, tables, etc., use two-letter postal abbreviations (10.27): CA, DC, and the US.
Words such as state, county, city, and so forth are capitalized when they are used as an accepted part of a proper name, even when pluralized (8.51, 8.53): Alameda County, Marin and Napa Counties; Washington State; Southern California but southern Idaho.
Punctuation and Spacing
Capitalize a word that follows a colon only if it starts a complete thought (6.63).
Include these items: aspirin, gauze, and tape.
Here’s the reason: Many nurses wear soft-soled shoes.
For number ranges, use an en dash: 2004–2007, pp. 4–9.
Windows users can form an en dash in Word with Ctrl+Numpad minus.
Windows users can form an em dash with Ctrl+Alt+Numpad minus, and add a space before and after: Several sources — Health Affairs, TIME, and Newsweek.
Ellipsis points represent text omitted from a quoted passage. Use three spaced periods within sentences (13.50) and four spaced periods between sentences (13.53).
I will apply . . . all measures that are required. . . . I will remember that there is art to medicine as well as science.
Parentheses and brackets
Always use in pairs, even in run-in lists (6.129): (1) California, (2) New York.
When making a parenthetical statement within another one, use brackets for the innermost set (6.99).
(For details, see Tyson  and Anderson .)
Use i.e. and e.g. only in parentheses, add periods, and follow with a comma (10.42): (i.e., this way).
Place commas and periods inside quotation marks (6.9), colons and semicolons outside (6.10).
Place question marks and exclamation marks inside only if they are part of the quotation (6.10).
“That’s what I thought,” she said.
“Respect”: my all-time favorite song.
“What did the doctor say?” he asked.
Did he say, “The doctor went home”?
The meaning of a slash (/) is often unclear. Does it mean or, and, both, or something else? Given this lack of clarity, avoid the slash and use words to make meaning clear: Californians can apply for Medicare and Medi-Cal.
Also, avoid the awkward and/or construction by spelling out the options: Members receive care through a commercial health plan, Medi-Cal, or both.
Use only one space between sentences and after colons (2.9). Avoid using more than one space in a row for any reason. To align columns, for example, use tabs (2.11).
Unless dictated otherwise by the source material (8.38), use the terms below. Where a source’s terms differ, either add a note (e.g., “Data source uses African American and Native American.”) or paraphrase results (e.g., “The results indicate that Latinos/x were 12% less likely to have insurance.”).
American Indian and Alaska Native (AIAN)
Asian, Native Hawaiian, and Pacific Islander (ANHPI)
Black people (not Blacks)
Latino/x or Latina/x (sing.), Latinos/x or Latinas/x (pl.) (people of Latin American ancestry)
Native Hawaiian and Pacific Islander (NHPI)
White people (not Whites)
Not all Black people (e.g., Caribbean Americans and those born outside the US) are African Americans. In a publication in which race is relevant and there is no stated preference, use Black.
Where a source uses Alaskan Native or separates American Indian and Alaska Native, or Native Hawaiian and Pacific Islander, with a slash or with or (e.g., Alaska Native / American Indian), simply replace it with the standard wording above, without comment.
If used by the source material or preferred by the subject, African American should not be hyphenated even as an adjective; Indigenous should be capitalized.
Avoid using minority or Black, Indigenous, and other people of color or BIPOC (use people of color) or brown as race categories except in a direct quote.
Use ordinal numbers (9.6): they came in 57th in the state.
Use AM or PM with a leading space (10.41) and time zone (but without Daylight/Standard designation): 8:00 AM (PT), 2:30 PM (PT). Use Noon where appropriate.
For ranges, separate the times with an en dash but no surrounding spaces: Noon–1:30 PM (PT), 10:30 AM–1:00 PM (PT).
Except in articles and blog posts, use the third person, avoiding I, we, and us: not we found but instead the authors found.
Avoid language that suggests that organizations can talk: health plans stated. Instead, identify the person or people who did the speaking: health plan interviewees stated, health plan representatives stated, a health plan rep stated.
Spelling and Vocabulary
If a term is not in this list, consult M-W. If an entry has more than one spelling, use the first one.
911, 988 (phone numbers)
AB nnnn or SB nnnn (use a nonbreaking space, e.g., AB 5410)
accountable care organization
acute care (n. and adj.)
administrative services only (ASO)
adult residential facilities
advance care planning
Advanced Planning Document
advance health care directive
adviser (not advisor)
African American (n. and adj.)
Agency for Healthcare Research and Quality (AHRQ)
all-payer claims database (APCD)
All Plan Letter
Alternative Benefit Plan
alternative payment method
alternative payment model
ambulatory care–sensitive conditions (note en dash)
appendices (not appendixes)
application (or app)
back office (n.), back-office (adj.)
behavioral health (includes mental health & addiction)
beneficiary (avoid; use enrollee)
biannual (avoid; use either biennial [every two years] or semiannual [twice a year])
birthing people* (add this footnote: * We use “birthing people” to recognize that not all people who become pregnant and give birth identify as women or mothers.)
brand name (n.), brand-name (adj.)
bronze (ACA plan level)
buy-in (n.), buy in (v.)
CalAIM (California Advancing and Innovating Medi-Cal)
CalHEERS (California Healthcare Eligibility, Enrollment, and Retention System)
California Health Benefit Exchange
California Health Care Foundation (CHCF, the foundation)
Cal MediConnect Program
CalPERS (California Public Employees’ Retirement System)
carve-out (n. and adj.), carve out (v.)
Center for Medicare and Medicaid Innovation (CMMI) (sing., no ampersand)
Centers for Disease Control and Prevention (CDC) (note plural, no ampersand)
Centers for Medicare & Medicaid Services (CMS) (note plurals and ampersand)
checkup (n.), check up (v.)
Children’s Health Initiative
Children’s Health Insurance Program (CHIP)
chronic care (n. and adj.; in general, do not hyphenate modifiers of “care” but long-term care)
clinic (avoid; generally refers to non-FQHC clinics; the distinction should be made clear)
Collaborative Care Model (CoCM)
community health center (CHC or health center) (On first use, add a footnote identifying the types of included organizations; e.g.: “In this publication, CHCs include FQHCs, FQHC Look-Alikes, and other health center program grantees, as well as non-FQHC clinics.” For example, some data sets do not include non-FQHC clinics or may not include FQHC Look-Alikes, in which case the footnote should be clear about which data are or are not included.)
community health worker/promotor (sing.), community health workers/promotores (pl.)
consumer (avoid; use person, enrollee, member, client, resident, a pronoun, or other appropriate term)
Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Continuum of Care (CoC), Continuums of Care (CoCs)
coordinated care organization
Coronavirus Aid, Relief, and Economic Security (CARES) Act
cost containment (n.), cost-containment (adj.)
cost-effective (adj.), cost-effectiveness (n.)
cost sharing (n.), cost-sharing (adj.)
County Organized Health System (COHS)
COVID-19 (not COVID; disease caused by SARS-CoV-2 virus)
critical access hospital
cutoff (n. and adj.), cut off (v.)
data (plural: data are) (5.250)
Data Exchange Framework
data sharing (n. and adj.)
Delivery System Reform Incentive Payments (DSRIP)
Department of Health Care Services’s (poss.)
designated public hospital
Direct secure messaging (Direct is a brand name)
disproportionate share hospital
District of Columbia (spelled out in list of states)
doctor of osteopathic medicine (not doctor of osteopathy)
Drug Medi-Cal Organized Delivery System (DMC-ODS)
DSM-IV, DSM-IV-TR, DSM-5
dually eligible enrollees (not duals or dual eligibles) (define term first — e.g., . . . people eligible for and enrolled in both Medicaid and Medicare, or dually eligible enrollees.)
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
electronic consultation (eConsult)
emergency medical services agency (used generically)
Enhanced Care Management (ECM)
essential health benefits (EHBs)
exchange (when referring to California’s exchange)
External Quality Review Organization
Family PACT (Family Planning, Access, Care, and Treatment)
Federal Employees Health Benefits Program (FEHBP)
Federally Qualified Health Center (FQHC) (an FQHC) (specifically, FQHC program 330 grantees; if including Look-Alikes, use FQHCs and FQHC Look-Alikes)
Federally Qualified Health Center Look-Alike
Federal Medical Assistance Percentage (FMAP)
federal poverty guidelines
federal poverty level (FPL)
fee-for-service, Fee-for-Service (n. and adj.)
follow-up (n. and adj.), follow up (v.)
front line (n.), frontline (adj.)
front office (n.), front-office (adj.)
Full Integration Plan
Full Service Partnership
full time (n.), full-time (adj. and adv.)
Geographic Managed Care Model or GMC Model
gold (ACA plan level)
graduate medical education
grandfathered (avoid — use legacy or reword)
handoff (n.), hand off (v.)
Healthcare Effectiveness Data and Information Set (HEDIS)
health care, health care plan (n. and adj.)
Healthforce Center at UCSF (do not precede with the)
Health Homes Program (HPP)
health information exchange (an HIE)
health information organization or health information exchange organization (an HIO)
Health Professional Shortage Area
health savings account
high-need, high-cost population (avoid; use more descriptive and specific language such as patients with multiple chronic conditions who account for a disproportionate share of health care spending)
HIPAA (Health Insurance Portability and Accountability Act)
HITECH (Health Information Technology for Economic and Clinical Health) Act
home and community-based services (HCBS)
hospital fee program
hub and spoke program (or system)
independent medical review
independent practice association
Indigenous (capitalize when referring to people)
individual (avoid except when comparing to families or groups; use person, people, or patients)
In-Home Supportive Services (IHSS)
in-house (adj. and adv.)
In Lieu of Services (ILOS)
in-network (adj.), in network (adv.)
in-person (adj.), in person (adv.)
KFF (Kaiser Family Foundation) not Kaiser Family Foundation (KFF)
kickoff (n.), kick off (v.)
Knox-Keene (formally Knox-Keene Health Care Service Plan Act of 1975)
La Clínica de la Raza (note accented i)
Latino/x or Latina/x, Latinos/x or Latinas/x (not Hispanic)
learnings (avoid — use lessons, discoveries, findings, insights, takeaways)
Level I, Level II trauma center
LGBTQ (not LGBT)
LifeLong Medical Care
long COVID (define and use quotes on first use, ok to leave off “-19” from this phrase)
long-term care (n. and adj.)
long-term services and supports (LTSS)
Low Income Health Program
managed care plan (an MCP; not managed care organization)
“meaningful use” (use quotations marks on first use)
Medicaid and CHIP Payment and Access Commission (MACPAC)
Medicaid Home and Community-Based Services
Medicaid managed care
Medicaid State Plan
Medi-Cal (always refer to Medicaid in California as Medi-Cal)
Medi-Cal 2020 waiver
Medi-Cal Access Program (MCAP)
Medi-Cal enrollee (not beneficiary)
Medi-Cal managed care
Medi-Cal managed care program
medical doctor (avoid — use doctor of medicine)
medical loss ratio
Medicare Part D
methodology (generally, avoid — use method)
mHealth (mobile health)
mindfulness-based stress reduction
morphine equivalent dose (avoid — use MME)
morphine milligram equivalents (MME)
National Committee for Quality Assurance (NCQA)
nonprofit (not not-for-profit)
number one, number one–rated (note en dash)
nurse practitioner (an NP)
ob/gyn (not OB/gyn or OB/GYN) (capped form: Ob/Gyn)
Office of Statewide Health Planning and Development (avoid, now Department of Health Care Access and Information (HCAI))
Office of the National Coordinator for Health Information Technology (ONC)
on-site (adj. and adv.)
opioid-dependent, frequent [ED or services] user (not frequent user or high utilizer/user)
opioid treatment program
opioid use disorder
osteopathic medicine (not osteopathy)
osteopathic physician (not osteopath or osteopathic doctor)
out-of-network (adj.), out of network (adv.)
out-of-pocket (adj.), out of pocket (adv.)
PACE (Program of All-Inclusive Care for the Elderly)
Pacific Business Group on Health (avoid; now Purchaser Business Group on Health)
Partnership HealthPlan of California (capped P, no space in HealthPlan)
part time (n.), part-time (adj. and adv.)
patient-centered medical home
payer (not payor)
pay for performance (n.), pay-for-performance (adj.) or P4P
per-member per-month or per-person per-month (adj.)
per member per month or per person per month (adv.)
persons (avoid, use people, populations, those, or the like)
per user per month (avoid per utilizer per month)
pharmacological (not pharmacologic)
Physician Orders for Life-Sustaining Treatment (POLST)
platinum (ACA plan level)
population health management (concept)
Population Health Management (CalAIM program)
populations of focus
pop-up (n. and adj.)
Prescription Drug Monitoring Program (PDMP)
preventive (not preventative)
primary care, primary care physician (no hyphen even as adj.)
program (not program area)
promotor (sing.), promotores (pl.)
prospective payment system (PPS)
psychiatric/mental health nurse practitioners
public health emergency
qualified health plan
Quality Improvement Organization
quick reference guide
real time (n.), real-time (adj.)
Regional Model (Medi-Cal managed care)
residential care facilities for the elderly
an RFP, an RFQ (not a)
rollout (n.), roll out (v.)
routine care, signs, and symptoms
Rural Health Clinic
safety net (n.), safety-net patient (adj.)
Schedule I, Schedule II (drug)
scope of practice (n. and adj.)
Screening, Brief Intervention, and Referral to Treatment (SBIRT) services
Section 1115 waiver
seniors and people with disabilities (not persons)
shared savings (n. and adj.)
shelter in place (v.), shelter-in-place (n. and adj.)
sign-up (n. and adj.), sign up (v.)
silver (ACA plan level)
skilled nursing facility
SNF (skilled-nursing facility, pronounced “sniff” so a SNF)
social determinants of health (SDOH)
specialty mental health services
stage I, stage II (cancer)
start-up (n. and adj.)
state exchanges, exchanges in general
State Plan, State Plan Amendment (a SPA)
Substance Abuse and Mental Health Services Administration (SAMHSA)
substance use disorder (an SUD)
Targeted Case Management
Teaching Health Center
topline (n. or adj.)
trade-off (n.), trade off (v.)
transgender on first use; transgender or trans thereafter
treatment authorization request
Two-Plan Model (Medi-Cal managed care)
type 1, type 2 diabetes (7.89)
UC campuses: UCLA, UCSF, UC Berkeley (other campuses spelled out on first mention, with commas before and after city when used alone, but University of California Davis School of Medicine; in lists, use consistent format)
up-front (adj.), up front (adv.)
the Urban Institute
versus (spell out in running text; vs. can be used in tables, heads, etc.; use v. for legal cases)
Veterans Administration (avoid except for historical references; use Department of Veterans Affairs)
web page (7.80)
whole-person care (health care concept)
Whole Person Care Pilot program, WPC pilots (DHCP program)
workers’ compensation insurance
workplace (n. and adj.)
x-ray (n. and adj.)
X-waiver (DEA license)
year-end (n. and adj.)