Bibliography

The Johns Hopkins ACG® System Bibliography provides links to more than 900 papers and reports from across the globe detailing various studies utilizing the ACG System in a variety of locations, populations, and innovative applications.

Please use the below search box to find articles on specific topics or keywords. You can also use the filters below to refine further.

Physician referral rates: style without much substance?

Med Care 38:836-846. Department of Family Medicine, University of Rochester, New York, NY, USA BACKGROUND: Primary care physicians (PCPs) exhibit widely varying referral rates, resulting […]

Capitation payment systems – risk factor estimation

Academia Economic Papers 28:231-261. Published in Chinese. PURPOSE: To explore risk factors that can explain individual medical expenditure. SAMPLE: Subjects included in “1996 NHI Satisfaction […]

Ambulatory Care Groups as a primary care patient classification system

Cuadernos de Gestión 6:19-24. Published in Spanish. Fundació Jordi Gol i Gurina, Barcelona, Spain No abstract

Updating and calibrating the Johns Hopkins University ACG/ADG risk adjustment method for application to Medicare risk contracting

Final report to Health Care Financing Administration. Baltimore, MD, USA: Johns Hopkins University. Johns Hopkins University, Baltimore, MD, USA The Balanced Budget Act (BBA) of […]

Health-risk-assessment tools used to predict costs in defined populations

J Healthc Inf Manag 14:31-57. Vanderbilt University Medical Center, Nashville, TN, USA With the Balanced Budget Act of 1997 mandating that the Health Care Financing […]

Risk adjustment lexicon

Reporting Framework Subcommittee of the Steering Committee of the Minnesota ACG Users Group. Revised by Chad Abrams, Terry Bernhardt, Steven Foldes, Jason Wiley, May 17, […]

Provider profiling: doing it right

Healthplan 41:74-79. Medstat Group, Washington, DC, USA Managed care plans are a type of health insurance. They have contracts with health care providers and medical facilities […]

Is it necessary that some patients come to see us so often? Factors associated with primary care use in pediatrics

Gac Sanit 14:195-202. Published in Spanish. Centro de Salud de Astrabudúa (Bizkaia), Osakidetza-Servicio Vasco de Salud, Bilbao, Spain OBJECTIVES: To analyze the relationship between pediatric […]

Emergency department use by the rural elderly

J Emerg Med 18:289-297. Department of Family Medicine, University of Washington, Seattle, WA, USA This study uses Medicare data to compare emergency department (ED) use […]

Do physicians who diagnose more mental health disorders generate lower health care costs?

J Fam Pract 49:305-310. University of Rochester School of Medicine, New York, NY, USA BACKGROUND: Underrecognition and undertreatment of mental health disorders in primary care […]

Why do physicians vary so widely in their referral rates?

J Gen Intern Med 15:163-168. Department of Family Medicine, University of Rochester, Rochester, NY, USA OBJECTIVE: To determine which physician practice and psychological factors contribute […]

Risk adjustment of capitation payments to behavioral health care carve-outs: how well do existing methodologies account for psychiatric disability?

Health Care Manag Sci 3:159-169. Division of General Internal Medicine and Health Services Research, UCLA Department of Medicine, Los Angeles, CA, USA This study used […]

ACG case-mix system aids contract assessment, improves performance

Data Strateg Benchmarks 4:21-26. The ABCs of ACGs. Adjusted clinical groups, or ACGs, a risk adjustment system developed by Baltimore-based Johns Hopkins University, are being […]

Risk adjusting capitation: applications in employed and disabled populations

Health Care Manag Sci 3:101-109. Department of Health Services, University of Washington, Seattle, WA, USA Risk adjustment may be a sensible strategy to reduce selection […]

The effect of the doctor-patient relationship on emergency department use among the elderly

Am JPublic Health 90:97-102. Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA OBJECTIVES: This study sought to determine the rate […]

Medi-Cal and managed care: risk, costs, and regional variation

Sacramento, CA, USA: Public Policy Institute of California. Rollins School of Public Health, Emory University, Atlanta, GA; School of Public Health, University of Alabama at […]

Risk aversion and costs: a comparison of family physicians and general internists

J Fam Pract 49:12-17. Department of Family Medicine, University of Rochester, New York, NY, USA No abstract Comment in: Interspeciality differences in medical resource utilization. […]

Minimal-burden risk adjusters for the Medicare risk program

Medical College of Virginia Associated Physicians, Mathematica Policy Research. Report prepared for the Health Care Financing Review (HCFA Contract No. 17C-90366/3/01). Washington, DC, USA: Mathematica […]

The development of Ambulatory Care Groups in primary care

Rev Neurol 29:667-669. Published in Spanish. Fundació Jordi Gol i Gurina, Barcelona, España INTRODUCTION: Ambulatory care groups (ACG) are a system of classification for patients […]

Development and estimation of a pediatric chronic disease score using automated pharmacy data

Med Care 37:874-883. Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA, USA BACKGROUND: Although risk assessment models for specific adult populations […]

The Adjusted Clinical Group (ACG) reporting framework

Reporting Framework Subcommittee of the Steering Committee of the Minnesota ACG Users Group. St. Paul, MN, USA: Minnesota ACG Users Group. Minnesota ACG Users Group, […]

Risk distribution and risk assessment among enrollees in Washington state’s Medicaid SSI population

Hamilton, NJ, USA: Center for Health Care Strategies. Center for Health Care Strategies, Hamilton, NJ, USA Washington state began enrolling Medicaid SSI (low income, disabled) […]

Description, behavior, use and methodology used to measure case mix in our primary health care system: the Ambulatory Care Groups (ACGs)

Barcelona, Spain: Fundacio Salut, Empresa i Economia. Published in Spanish. Fundacio Salut, Empresa i Economia, Barcelona, Spain No abstract

Risk adjustment and Medicare

New York, NY, USA: Commonwealth Fund. Division of Health Policy Research and Education, Harvard University, Boston, MA, USA Almost all observers agree in principle that […]

Measuring morbidity in populations: performance of the Johns Hopkins Adjusted Clinical Group (ACG) case-mix adjustment system in Manitoba

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada This study examined the performance of the Johns Hopkins […]

Medicaid managed care payment rates in 1998

Health Aff 18:217-227. Urban Institute, Washington, DC, USA This paper reports on a new survey of state Medicaid managed care payment rates. We collected rate […]

The prospective risk adjustment system

J Ambul Care Manage 22:41-52. 3M Health Information Systems, Wallingford, CT, USA The Episode Classification System is intended to perform two tasks. First, it will […]

The duration of ambulatory visits to physicians

J Fam Pract 48:264-271. Institute for Health Policy, Massachusetts General Hospital/Partners HealthCare System, Harvard Medical School, Boston, MA, USA BACKGROUND: The objective of our study […]

Variations in primary care physician referral rates

Health Serv Res 34:323-329. University of Rochester, Rochester, NY, USA OBJECTIVE: To examine primary care physician referral rate variations, including their extent and their stability […]

Application of the Ambulatory Care Groups in the primary care of a European national health care system: does it work?

Med Care 37:238-248. Astrabudúa Health Center, Osakidetza/Basque Health Service, Bizkaia, Spain BACKGROUND: Ambulatory Care Groups (ACGs), a US case mix system that uses the patient […]

Methods of reducing the financial risk of physicians under capitation

Arch Fam Med 8:149-155. Johns Hopkins Center for Hospital Finance and Management, Baltimore, MD, USA. In today’s rapidly changing medical marketplace, managed care plans are […]

Methods for analyzing health care utilization and costs

Annu Rev Public Health 20:125-144. Department of Biostatistics, University of Washington, Seattle, WA, USA Important questions about health care are often addressed by studying health […]

Performance of an ambulatory case-mix measurement in primary care in Spain: Ambulatory Care Groups (ACGs)

Eur J Public Health 9:27-35. Unitat d’Investigació Centre del Institut Catalá de la Salut, Barcelona, Spain BACKGROUND: Patient classification systems based on the defining of […]

The risk-adjustment debate

N Engl J Med 339:1952-1956. Risk adjustment refers to the adjustment of payments to health plans (or to doctors) to reflect more accurately the actual […]

Building health plan databases to risk adjust outcomes and payments

Int J Qual Health Care 10:531-538. Center for Health Research, Kaiser Permanente, Northwest Division, Portland, OR, USA OBJECTIVES: To highlight the types and sources of […]

Health-based payment and computerized patient record systems

Eff Clin Pract 1:66-72. Center for Health Research, Kaiser Permanente, Northwest Division, Portland, OR, USA. Health care information technology is changing rapidly and dramatically. A […]

The importance of continuity of care in the likelihood of future hospitalization: is site of care equivalent to a primary clinician?

Am J Public Health 88:1539-1541. Department of Family Medicine, Medical University of South Carolina, Charleston, SC, USA OBJECTIVES: This study examined the effect of continuity […]

The development of a risk-adjusted capitation payment system: the Maryland Medicaid model

J Ambul Care Manage 21:29-52. School of Public Health, Johns Hopkins University, Baltimore, MD, USA This article describes the risk-adjusted payment methodology employed by the […]

The role of provider continuity in preventing hospitalizations

Arch Fam Med 7:352-357. Department of Family and Community Medicine, Christiana Care Health System, Wilmington, DE, USA OBJECTIVES: To examine the association between provider continuity […]

The importance of the data quality in the validation of the ACG case mix

Ambulatory Care Groups. Aten Primaria 22:128. Published in Spanish. Osakidetza Servicio Vasco de Salud, Bizkaia, Spain No abstract Comment on:[A retrospective evaluation of the behaviour […]

Implementing a model for risk distribution among competing health plans

Final report. Princeton, NJ, USA: Robert Wood Johnson Foundation.

How well do models work? Predicting health care costs

In: American Statistical Association, eds. Proceedings of the Section on Statistics in Epidemiology. Alexandria, VA, USA: American Statistical Association:42-49. Department of General Internal Medicine, Boston […]

Differences in case mix between CHC users and non users: Washington and Missouri

MDS Associates, Laguna Research Associates. Final report to the Bureau of Primary Health Care. Wheaton, MD, USA: MDS Associates. Wheaton, MD, USA; San Francisco, CA, […]

Employer purchasing coalitions and Medicaid: experiences with risk adjustment

New York, NY, USA: Commonwealth Fund. Commonwealth Fund, New York, NY, USA Choice among health plans increases patient satisfaction with care and enables families to […]

Primary care physician compensation method in medical groups: does it influence the use and cost of health services for enrollees in managed care organizations?

JAMA 279:853-858. Department of Health Services, University of Washington, Seattle, WA, USA CONTEXT: Growth of at-risk managed care contracts between health plans and medical groups […]

Managed care holds down costs, doesn’t hurt quality

Minneapolis Star Tribune, January 3:A13. No abstract

The Florida MediPass program

Chapter 4. In: Gavin NI, Farrelly MC, ed. Evaluation of Medicaid managed care programs with 1915(b) waivers. Presented to HCFA Office of R&D. Rockville, MD, […]

The New Mexico primary care network

Chapter 5. In: Gavin NI, Farrelly MC, ed. Evaluation of Medicaid managed care programs with 1915(b) waivers. Presented to HCFA Office of R&D. Rockville, MD, […]

Risk adjustment and rate setting methods in public programs

A report to legislature. St. Paul, MN, USA: Minnesota Department of Health. Health Economics Program, Minnesota Department of Health, St. Paul, MN, USA The 1995 […]

Case study: the Minneapolis Buyers Health Care Action Group

Inquiry 35:171-177. Health Research Center, Institute for Research and Education, Health System Minnesota, Minneapolis, MN, USA Managed care plans are a type of health insurance. They […]

Risk adjustment of mental health and substance abuse payments

Inquiry 35:223-239. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA This study used 1992 and 1993 data from private employers to compare […]

Cost benefit analysis of pharmaceutical care in a Medicaid population – from a budgetary perspective

J Managed Care Pharm 4:303-308. Nova Southeastern University, Ft. Lauderdale, FL, USA The objective was to evaluate the economic impact of Medicaid pharmaceutical care services […]

Preventable hospitalizations and socioeconomic status.

Health Aff 17:177-189. Wagner Graduate School, New York University, New York, NY, USA. “Preventable” hospitalizations have been proposed as indicators of poor health plan performance. […]

Adjust utilization for case mix and make physicians responsible for remaining variation

Data Strateg Benchmarks 2:25-28. “But my patients are sicker!” Health Source/CIGNA put a stop to this physician complaint by switching to quarterly physician profiles that […]

A retrospective evaluation of the behaviour of groups under out-patient care at a health center

Aten Primaria 21:36-42. Published in Spanish. Escuela Andaluza de Salud Pública de Granada, Granada, Spain OBJECTIVES: To study and analyse the Out-Patient Care Groups (OCGs), […]

Children’s health care use in the Healthy Kids Program

Pediatrics 100:947-953. Department of Pediatrics, University of Florida, Gainsville, FL, USA BACKGROUND: In 1990, the Florida Legislature established the Florida Healthy Kids Corporation to implement […]

Hopkins health pricing tool a managed care hit

Hopkins health pricing tool a managed care hit. Baltimore Business Journal July 21. Baltimore Business Journal, Baltimore, MD, USA Johns Hopkins University’s links with private […]

ACGs: an ambulatory care case-mix measure. Health Quality section update

Center for Health Quality Outcomes and Economic Research. Bedford, MA, USA: CHQOER Quarterly, ENRM VA Hospital. Center for Health Quality Outcomes and Economic Research, Bedford, […]

A patient classification system for our primary care: the Ambulatory Care Groups (ACGs)

Gac Sanit 11:83-94. Published in Spanish. Unitat d’Investigació Centre del Institut Catalá de la Salut, Barcelona, Spain OBJECTIVES: The ambulatory care groups (ACGs) were developed […]

How well do Ambulatory Care Groups predict expenditures on mental health and substance abuse patients?

Adm Policy Ment Health 24:339-357. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA This paper evaluates the ability of Ambulatory Care Groups […]

Performance of risk adjusted capitated systems in allocating a global budget

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Johns Hopkins University, Baltimore, MD, USA Rapidly rising health care costs in the United States have led […]

Taking health status into account when setting capitation rates: a comparison of risk-adjustment methods

JAMA 276:1316-1321. Health Research Center, Institute for Research and Education, HealthSystem Minnesota, Minneapolis, MN, USA OBJECTIVE: To compare performance of different health status measures for […]

Systemwide provider performance in a Medicaid program. Profiling the care of patients with chronic illnesses

Med Care 34:798-810. Department of Health Policy and Management, Johns Hopkins University School of Public Health, Baltimore, MD, USA OBJECTIVES: This study illustrates how claims […]

Capitation adjustment for pediatric populations

Pediatrics 98:10-17. Institute for Research and Education, HealthSystem Minnesota, Minneapolis, MN, USA OBJECTIVE: The objective of this study is to assess the predictive performance of […]

Evaluation of casemix adjustment methods for the Massachusetts Division of Medical Assistance

Massachusetts Rate Setting Commission. Final report and recommendation. Boston, MA, USA: Massachusetts Rate Setting Commission. Massachusetts Rate Setting Commission, Boston, MA, USA We investigated methods […]

The development and testing of risk adjusters using Medicare inpatient and ambulatory data

Final report for Health Care Financing Administration contract 93-026/EE. Falls Church, VA, USA: Lewin Group. Lewin Group, Falls Church, VA, USA The Health Care Financing […]

Developing re-insurance and carve-out risk adjusters for an under 65 population

Johns Hopkins University, Lewin Group. Prepared for Health Care Financing Administration. Fairfax, VA, USA: Lewin Group. Johns Hopkins University, Baltimore, MD, USA; Lewin Group, Fairfax, […]

Quality assessment: is the focus on providers or on patients?

Int J Qual Health Care 8:231-241. Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA Most studies of ambulatory care quality are based on chart […]

Profiling resource use by primary-care practices: managed Medicare implications

Health Care Financ Rev 17:23-42. Project HOPE Center for Health Affairs, Bethesda, MD, USA Variations in elderly Medicare beneficiaries’ health service use are examined using […]

Risk-adjusted Medicare capitation rates using ambulatory and inpatient diagnoses

Health Care Financ Rev 17:77-99. Johns Hopkins School of Public Health, Baltimore, MD, USA Researchers at The Johns Hopkins University (JHU) developed two new diagnosis-oriented […]

Ambulatory care practice variation within a Medicaid program

Health Serv Res 30:751-770. Johns Hopkins University, School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA STUDY QUESTIONS: What is the […]

Ambulatory Care Groups and the profiling of primary care physician resource use: examining the application of case mix adjustments

J Ambul Care Manage 19:86-89. Center for Research in Ambulatory Health Care Administration, Englewood, CO, USA A variety of profiling models and tools is utilized […]

Health information services technologies

J Ambul Care Manage 19:90-97. ISYS Group, Des Moines, IA, USA Increasing demands for provider profiling have led to the growth of health information services […]

Profiling primary care physician resource use: examining the application of case mix adjustment

J Ambul Care Manage 19:60-80. Health Services Research and Development Center, Johns Hopkins School of Public Health, Baltimore, MD, USA Growing emphasis on managed care […]

Classification systems in case-mix groups in ambulatory care. Perspectives for our primary health care

Aten Primaria 17:76-82. Published in Spanish. Unitat d’Investigació Centre, Institut Català de la Salut, CESCA, Barcelona, Spain No abstract PMID: 8742149

Geographic variation in primary care visits in Iowa.

Health Serv Res 30:657-671. Graduate Program in Hospital and Health Administration, University of Iowa, Iowa City, IA, USA. OBJECTIVE: This study investigates the determinants of […]

HMO family physicians: men and women differ in their work

HMO Pract 9:155-161. Group Health Cooperative of Puget Sound, Seattle, WA, USA OBJECTIVE: The goal was to identify differences in the type of work and […]

A chronic disease score with empirically derived weights

Med Care 33:783-795. Indiana University Department of Medicine, Indianapolis, IN, USA. Different types of medication prescribed during a 6-month period for the treatment and management […]

A comparative analysis of methods of health risk assessment: final report

Cambridge, MA, USA: Harvard University School of Public Health. Harvard University School of Public Health, Cambridge, MA, USA A key component of many recent proposals […]

Assessment of Ambulatory Care Groups with comparison to existing ambulatory case-mix classification systems

Systems Research and Applications Corporation. Arlington, VA, USA: Systems Research and Applications Corporation. Systems Research and Applications Corporation, Arlington, VA, USA The Office of the […]

Models for Medicare payment system reform based on group-specific volume performance standards (GVPS)

Waltham, MA, USA: Brandeis University. Brandeis University, Waltham, MA, USA This report discusses potential policy options for Medicare based on Group-Specific Volume Performance Standards (GVPS). […]

Ambulatory care casemix measures

J Gen Intern Med 10:162-170. HSR&D Field Program, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA No abstract PMID: 7769475

Forecasting physician workforce requirements

JAMA 273:111; author reply 113. Dr Weiner1 presents an exacting analysis of the likely effects of health system reform on physician workforce requirements. His market approach […]

Designing and using measures of quality based on physician office records.

J Ambul Care Manage 18:56-72. Harvard School of Public Health, Harvard University, Boston, MA, USA This article presents our principles for developing performance measures to […]

Costs vs quality in different types of primary care settings

JAMA 272:1903-1908. Department of Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD, USA OBJECTIVE: To determine the relationship […]

The case for case-mix adjustment in practice profiling. When good apples look bad

JAMA 272:871-874. Harvard Community Health Plan, Brookline, MA, USA OBJECTIVE: To assess the influence of patient characteristics on practice profiling. Using the example of specialty […]

A comparison of alternative approaches to risk measurement

Final report, grant number 93-G07, Physician Payment Review Commission. Minneapolis, MN, USA: Park Nicollet Medical Foundation. Park Nicollet Medical Foundation, Minneapolis, MN, USA Under health […]

The ambulatory case-mix development project

Project final report. Baltimore, MD, USA: Johns Hopkins University and Aetna Health Plans. Johns Hopkins University and Aetna Health Plans, USA As the US health […]

Applying population-based case mix adjustment in managed care: the Johns Hopkins Ambulatory Care Group system

Manag Care Q 2:21-34. CSC Healthcare Systems, Inc., Malden, MA, USA When analyzing medical utilization or other health care-related measurements across provider panels, case mix […]

Ambulatory Care Groups: an evaluation for military health care use

Fort Sam Houston, TX, USA: United States Army Center for Healthcare Education and Studies, publication #HR 94-004. United States Army Center for Healthcare Education and […]

Patient-mix differences among ambulatory providers and their effects on utilization and payments for Maryland Medicaid users

Med Care 31:1119-1137. Policy and Health Statistics Administration, Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA Characteristics of the usual source of care […]

Developing and evaluating performance measures for ambulatory care quality: a preliminary report of the DEMPAQ project

Jt Comm J Qual Improv 19:552-565. Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA Because of the focus on […]

Ambulatory encounter systems: implications for payment and quality

J Ambul Care Manage 16:33-49. Many key decision makers are looking to AESs solely for purposes of payment. This approach is unfortunate because many systems […]

Johns Hopkins Ambulatory Care Groups (ACGs). A case-mix system for UR, QA and capitation adjustment

HMO Pract 6:13-19. Johns Hopkins University, Baltimore, MD, USA This paper describes a new ambulatory case-mix system developed at The Johns Hopkins University and known […]

Case mix measures for ambulatory care

J Public Health Med 13:189-197. University of Newcastle upon Tyne, School of Health Care Sciences, Medical School, Newcastle, UK Resource management in Ambulatory Care is […]

Ambulatory case-mix methodologies: applications to primary care research

In: Grady M, eds. Primary care research: theory and methods. Washington, DC: USDHHS. AHCPR Pub 91-0011:75-81. Johns Hopkins University, Baltimore, MD, USA This paper describes […]

Development and application of a population-oriented measure of ambulatory care case-mix

Med Care 29:452-472. Department of Health Policy and Management, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD, USA This article describes a […]

Ambulatory care groups: a categorization of diagnoses for research and management

Health Serv Res 26:53-74. Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA This article describes a […]

Impact of managed care on prescription drug use

Health Aff 10:140-154. Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD, USA Differences between the health services utilization patterns of persons enrolled […]

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