One of the biggest challenges for health systems and large provider organizations is providing consistent, appropriate care across a wide range of locations, because certain sites will have entirely different health care needs than others. Some sites will have high-needs patients with many comorbidities, while others will have a healthier patient population. To understand this variation and address these needs efficiently and effectively, providers need analytics tools that can help them understand both current and predicted health resource use across multiple locations. With the ACG System, users can establish morbidity-adjusted benchmarks and targets, compare performance, and ultimately, customize care across multiple patient groups.
By comparing different provider panel data (the patients under a specific provider) with benchmarks or national averages, providers can pinpoint service areas where they are above or below average. This, paired with providers’ anecdotal expertise about their patients, helps provider organizations establish their collective and individual baselines – identifying areas of opportunity and setting achievable metrics of success. The ACG System’s nuanced casemix adjustment models allow an organization to understand underlying morbidity burden within each practice group and provider panel, and compare that burden to the population as a whole, to establish baselines and benchmarks for routine monitoring. The ACG System also calculates expected disease rates for a population based on age and sex demographics, to aid in trend monitoring and understand prevalence variations.
Having established a baseline, providers can use this information to support distinct provider sites and their patient populations toward successful outcomes and positive patient experiences. The ACG System assists providers in comparing performance between different settings with casemix-adjusted comparisons, which quantify performance of practice groups and providers, accurately accounting for underlying illness burden. In other words, the ACG System adjusts for the different casemixes (patient groups) in different settings.
The System goes a step further by generating expected metrics in several key domains, such as number of clinic visits, hospitalizations, and Emergency Department visits. Many ACG System users apply these measurements and outputs to create practice- and provider-level performance targets that account for each sub-group’s underlying morbidity burden. So, if one clinic happens to have a higher-needs population, and another has a lower-needs population, the ACG System identifies these differences and adjusts for them, allowing for a fair comparison of performance between locations.
Once the ACG System calculates comparisons to specific benchmarks and between different settings, it can help predict future health care utilization at particular provider locations and across patient populations. With routine monitoring of various sites’ metrics, providers can gain transparency into best practices in settings with healthier populations, while allocating additional resources or support programs to higher-need patient groups in other locations. Importantly, this distributes resources effectively toward the patient groups and settings that need them the most.
Ultimately, when it comes to providing health care services, providers know that a one-size-fits-all approach doesn’t work. The ACG System allows providers to drill down into each location’s unique patient mix and healthcare needs, providing a deep understanding of performance across diverse settings and showing the unique circumstances and needs of each. With this knowledge in hand, providers are analytically supported to provide customized care and manage the various health care needs of numerous patient groups within their organizational means.