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, […]

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 […]

Application of patient safety indicators in Manitoba: a first look.

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada Although there has always been an interest in patient […]

Analysis of practice variation due to payment methods across health insurance schemes

Khon Kaen, Thailand: Khon Kaen University. There are three public insurance schemes, the non-contributory Civil Servant Medical Benefit  Scheme (CS) for government employees, pensioners and […]

Risk adjustment in a European primary care context: assessing the properties of Adjusted Clinical Groups (ACG) for predictive modeling, for special populations and using ATC pharmacy codes

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Risk adjustment has become an essential tool in modern health services research and management. Specifically, it can […]

Comprehensive care coordination for chronically ill adults

Chapter 5: Intervention components. In: Schraeder C, Shelton PS, ed. Chichester, UK: Wiley-Blackwell:87-126. Care coordination seeks to bridge the gap between the needs of people […]

The association between usual health care utilization and stage at diagnosis in laryngeal cancer

Kingston, ON, Canada: Queen’s University (masters thesis). Queen’s University, Kingston, ON, Canada BACKGROUND: A significant number of laryngeal cancer patients are diagnosed with advanced-stage disease. […]

Adverse selection and inertia in health insurance markets: when nudging hurts

Am Econ Rev 103:2643-2682. University of California, Berkeley, CA, USA This paper investigates consumer inertia in health insurance markets, where adverse selection is a potential […]

Physician-level variation in practice patterns in the VA healthcare system

Health Serv Outcomes Res Methodology 3:95-106. Houston Center for Quality of Care and Utilization Studies, Veterans Affairs Medical Center, Houston, TX, USA; Baylor College of […]

Improve Patient Coordination Through Care Management

Coordinating care and sharing clinical information across the continuum of care has been shown to improve health care outcomes and health care delivery efficiencies. The […]

The Discovery Health experience with the ACG System in South Africa

Discovery Health The Discovery Health experience with the ACG System in South Africa Dr. Dianne Walker

Association between Continuity of Care and Avoidable Hospitalization in Taiwan

Veteran General Hospital – Taipei Continuity of Care and Its Association to Avoidable Hospitalizations of Taiwan’s Veterans: A Preliminary Study Ping Tao, RN., MHA


Johns Hopkins ACG System Future Directions and Opportunities in the Predictive Modeling and Risk Adjustment Fields: The Next 20 Years of the ACG System Jonathon […]

Tuesday-Management implications-Reams

Brown & Toland Physicians Using Risk Adjustment to Measure Access to Primary Care Kam Reams, MPhil, MPH Manager, Performance Improvement

Monday-Leveraging pharmacy data-Bodycombe

Johns Hopkins ACG System Expanded Horizons for Pharmacy Gap Analysis David Bodycombe

The development path for the ACG System

ACG System Johns Hopkins Bloomberg School of Public Health ACG v11 Introduction to New Tools for Understanding and Managing Population Health Stephen Sutch

Tuesday(C7)-Use of Adjusted Clinical Groups (ACGs) in implementing Chronic Disease Management Programs: preliminary experiences in north- eastern Italy

Use of Adjusted Clinical Groups (ACGs) in implementing Chronic Disease Management Programs: preliminary experiences in north- eastern Italy —Pietro Gallina, Carlo Rampazzo, Stefania Elvini, Domenico […]

Monday(C2)-Quality of Care in Multimorbid Patients-Shadmi

Quality of Care in Multimorbid Patients Efrat Shadmi, PhD, Ran D. Balicer, MD, MPH, PhD

Use of Johns Hopkins ACG System in the UK to Support Case Finding Similarities to the US Health Care System

What are the challenges facing health care in the UK? Are these similar or different to the challenges faced by the health care organizations in […]

Comparing Population-based Risk-stratification Model Performance Using Demographic, Diagnosis and Medication Data Extracted From Outpatient Electronic Health Records Versus Administrative Claims.

Department of Health Policy and Management, Johns Hopkins School of Public Health, Center for Population Health Information Technology, Baltimore, MD HealthPartners, Health Informatics Division, Bloomington, […]

Uptake of the Periodic Health Exam Among Adults With Intellectual and Developmental Disabilities from 2003 to 2015

Background: Over the past decade, annual heath exams have been de-emphasized for the general population but emphasized for adults with intellectual and developmental disabilities (IDD). […]

Assessing the Impact of Body Mass Index Information on the Performance of Risk Adjustment Models in Predicting Health Care Costs and Utilization

Abstract BACKGROUND: Using electronic health records (EHRs) for population risk stratification has gained attention in recent years. Compared with insurance claims, EHRs offer novel data […]

Days at Home in the Last 6 Months of Life: A Patient-Determined Quality Indicator for Cancer Care

ABSTRACT   PURPOSE: Quality end-of-life care (EoLC) is a key aspect of oncology. Days at home in the last 6 months of life represents a […]

Population Health Management Exploiting Machine Learning Algorithms to Identify High-Risk Patients

Abstract Population aging and the increase of chronic conditions incidence and prevalence produce a higher risk of hospitalization or death. This is particularly high for […]

Neuropsychological and Behavioral Outcomes after Exposure of Young Children to Procedures Requiring General Anesthesia

Abstract   BACKGROUND Few studies of how exposure of children to anesthesia may affect neurodevelopment employ comprehensive neuropsychological assessments. This study tested the hypothesis that […]

Profiling hospital performance on the basis of readmission after transcatheter aortic valve replacement in Ontario, Canada

Abstract Background Readmission rates are a widely accepted quality indicator. Our objective was to develop models for calculating case‐mixed adjusted readmission rates after transcatheter aortic […]

Development and Validation of a Score to Predict Acute Care Use After Initiation of Systemic Therapy for Cancer

Abstract Importance  Emergency department visits and hospitalizations after starting systemic therapy for cancer are frequent, undesirable, and costly. A score to quantify the risk of […]

Incidence, Treatment, and Implications of Kidney Stones During Pregnancy: A Matched Population-Based Cohort Study

Abstract Purpose To determine the incidence of kidney stones in pregnancy, the risk of adverse birth outcomes, and treatment trends. Methods We performed a population-based […]

Factors associated with emergency department presentation after total joint arthroplasty: a population-based retrospective cohort study

Abstract Background Unplanned visits to the emergency department after total joint arthroplasty are far more common than unplanned readmissions. Our objectives were to characterize the […]

Uptake and survival effects of minimally invasive surgery for lung cancer: A population-based study

Abstract Introduction Despite growing evidence supporting the safety of minimally invasive surgery (MIS) in the treatment of lung cancer, its uptake is still variable and […]

Shifts in office and virtual primary care during the early COVID-19 pandemic in Ontario, Canada

ABSTRACT BACKGROUND Globally, primary care changed dramatically as a result of the coronavirus disease 2019 (COVID-19) pandemic. We aimed to understand the degree to which […]

A Propensity Score–weighted Comparison of Outcomes Between Living and Standard Criteria Deceased Donor Kidney Transplant Recipients

Abstract Background Consider a theoretical situation in which 2 patients with similar baseline characteristics receive a kidney transplant on the same day: 1 from a […]

Costs Associated with Nontuberculous Mycobacteria Infection, Ontario, Canada, 2001–2012

Abstract Objective To determine incidence-based healthcare costs attributable to nontuberculous mycobacterial (NTM) pulmonary disease (PD) and NTM pulmonary isolation (PI), from the healthcare payer perspective […]

Frailty as a predictor of outcomes in patients undergoing head and neck cancer surgery

Abstract Objectives To evaluate whether frailty and functional measures are predictors of perioperative complications and length of hospital stay (LOS) in patients undergoing head and […]

Kidney Function and Potassium Monitoring After Initiation of Renin-Angiotensin-Aldosterone System Blockade Therapy and Outcomes in 2 North American Populations

Abstract Background Clinical practice guidelines recommend routine kidney function and serum potassium testing within 30 days of initiating ACE (angiotensin-converting enzyme) inhibitor or angiotensin II […]

Impact of High Deductible Health Plans on Diabetes Care Quality and Outcomes: Systematic Review

Abstract Objective High deductible health plans (HDHPs) were introduced as a mechanism to reduce healthcare spending by incentivizing patients to be more cost-conscious while making […]

Improving medication adherence and effective prescribing through a patient-centered prescription model in patients with multimorbidity

Abstract Purpose This study aimed to assess the impact of the patient-centered prescription (PCP) model in medication adherence and effective prescribing in patients with multimorbidity. […]

Indicators of publicly funded prescription opioid use among persons with traumatic spinal cord injury in Ontario, Canada

Abstract Objective To describe the proportion and identify predictors of community-dwelling individuals with traumatic spinal cord injury (TSCI) who were dispensed ≥1 publicly funded opioid […]

Association of a Care Coordination Model With Health Care Costs and Utilization The Johns Hopkins Community Health Partnership (J-CHiP)

Abstract Importance  The Johns Hopkins Community Health Partnership was created to improve care coordination across the continuum in East Baltimore, Maryland. Objective  To determine whether the Johns […]

Supporting Commissioning Activities

The first part of this webinar will provide an introduction to the ACG System, the logic used within the software to determine morbidity patterns and […]

Using the ACG System to support population health management in Baltimore city

Presented by: Melissa Sherry, MPH, CPH

Director, Population Health Innovation and Transformation, Johns Hopkins HealthCare

This webinar presents a case study of the use of the ACG System to address the needs of a high risk, low income population in Baltimore City.

Adjusted Clinical Groups as a risk assessment model for healthcare resource allocation

Rev Med Chil 142:153-160. Published in Spanish. Departamento de Desarrollo Estratégico, Ministerio de Salud. Santiago de Chile BACKGROUND: There is increasing interest in the study […]

Primary health care use from the perspective of gender and morbidity burden

BMC Womens Health 14:145. University of Zaragoza, Zaragoza, Spain; Aragon Health Sciences Institute, Zaragoza, Spain BACKGROUND: Sex and gender can interact to contribute to differences […]

Have we left some behind? Trends in socio-economic inequalities in breastfeeding initiation: a population-based epidemiological surveillance study

Can J Public Health 105:e362. Manitoba Centre for Health Policy, Winnipeg, MB, Canada OBJECTIVES: Breastfeeding is associated with improved health. Surveillance data show that breastfeeding […]

Comorbidity as a predictor of health services utilization and mortality in patients with diabetes

Gac Sanit 29:10-14. Published in Spanish. Universidad de Zaragoza, Zaragoza, España; Dirección General de Planificación y Aseguramiento, Zaragoza, España; Grupo de Investigación en Servicios Sanitarios […]

Patient sharing and quality of care: measuring outcomes of care coordination using claims data

Med Care 53:317-323. Johns Hopkins University, Baltimore, MD, USA BACKGROUND: With the goal of improving clinical efficiency and effectiveness, programs to enhance care coordination are […]

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 […]

Effect of socioeconomic status on hepatocellular carcinoma incidence and stage at diagnosis, a population-based cohort study

Liver Int. University of Toronto, Toronto, ON, Canada; Cancer Care Ontario, Toronto, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Ontario Institute for Cancer […]

Do pediatric patients who receive care across multiple health systems have higher levels of repeat testing?

Popul Health Manag. Intermountain Healthcare, Salt Lake City, UT, USA; University of Minnesota , Minneapolis, MN, USA; Children’s Hospitals and Clinics of Minnesota , Minneapolis, […]

Are family physicians comprehensively using electronic medical records such that the data can be used for secondary purposes?

A Canadian perspective. BMC Med Inform Decis Mak 15:67. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; University Health […]

Relationship between efficiency and clinical effectiveness indicators in an adjusted model of resource consumption: a cross-sectional study

BMC Health Serv Res 13:421. Institut Universitari d’investigació en Atenció Primària Jordi Gol, Barcelona, Spain BACKGROUND: Adjusted clinical groups (ACG®) have been widely used to […]

Renewing primary care: lessons learned from the Spanish health care system

Health Aff 29:1432-1441. Department of Family Medicine at the Alpert Medical School, Brown University, in Providence, RI, USA From 1978 on, Spain rapidly expanded and […]

Risk adjustment alternatives in paying for behavioral health care under Medicaid

Health Serv Res 36:793-811. UCLA Department of Medicine, Los Angeles, CA, USA OBJECTIVE: To compare the performance of various risk adjustment models in behavioral health […]

The interaction of ethnicity and chronic disease as risk factors for osteoporotic fractures: a comparison in Canadian Aboriginals and non-Aboriginals

Osteoporos Int 17:1358-1368. Department of Medicine, University of Manitoba, Winnipeg, MB, Canada INTRODUCTION: Efforts to develop global methods for absolute fracture risk prediction are currently […]

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 […]

Factors related to frequent usage of the primary healthcare services in old age: findings from the Swedish National Study on Aging and Care

Health Soc Care Community 17:304-311. Växjö University, School of Social Sciences, Växjö, Sweden People aged 60 or more are the most frequent users of healthcare […]

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 […]

Quantifying morbidities by Adjusted Clinical Group System for a Taiwan population: a nationwide analysis

BMC Health Serv Res 8:153. Department of Medical Affairs and Planning, Taipei Veterans General Hospital, Taipei City, Taiwan, ROC BACKGROUND: The Adjusted Clinical Group (ACG) […]

Case selection for a Medicaid chronic care management program

Health Care Financ Rev 30:61-74. Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA, USA Medicaid agencies are beginning to turn […]

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 […]

Impact of comorbidities on stroke rehabilitation outcomes: does the method matter?

Arch Phys Med Rehabil 89:1903-1906. Center for Health Quality, Outcomes and Economic Research, Bedford VA Hospital, Bedford, MA, USA OBJECTIVES: To examine the impact of […]

Pay for performance: an excellent idea that simply needs implementation

Qual Manag Health Care 14:31-44. 3M Health Information Systems, Wallingford, CT, USA Pay for performance cannot consist of a one-size-fits-all approach. Variation in quality and […]

Comparative study at 4 health centres of efficiency, measured on the basis of Ambulatory Care Groups

Aten Primaria 38:275-282. Published in Spanish. Badalona Serveis Assistencials, Badalona (Barcelona), España OBJECTIVE: To measure efficiency in the use of resources for the care lists […]

Do Adjusted Clinical Groups eliminate incentives for HMOs to avoid substance abusers? Evidence from the Maryland Medicaid HealthChoice program

J Behav Health Serv Res 30:63-77. UCLA Department of Medicine, Division of General Internal Medicine & Health Services Research, Los Angeles, CA, USA The adequacy […]

Cholecystostomy: a bridge to hospital discharge but not delayed cholecystectomy

J Trauma Acute Care Surg 74:175-179; discussion 179-80. Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON, Canada BACKGROUND: Current data on the clinical […]

Primary care safety-net delivery sites in the United States: A comparison of community health centers, hospital outpatient departments, and physicians’ offices

JAMA 284:2077-2083. Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD, USA CONTEXT: The US primary care safety net is […]

Psychiatric illness and subsequent traumatic brain injury: a case control study

J Neurol Neurosurg Psychiatry 72:615-620. Department of Psychiatry, University of Washington, Seattle, WA, USA OBJECTIVE: To determine whether psychiatric illness is a risk factor for […]

Population-based medical and disease management: an evaluation of cost and quality

Dis Manag 9:45-55. UMHS Medical Management Center, University of Michigan, Ann Arbor, MI, USA Reports by the Institute of Medicine and the Health Care Financing […]

Regression tree boosting to adjust health care cost predictions for diagnostic mix

Health Serv Res 43:755-772. Healthcare Management and Statistical Consulting, 4303 Stanford Street, Chevy Chase, MD, USA OBJECTIVE: To assess the ability of regression tree boosting […]

The contribution of longitudinal comorbidity measurements to survival analysis

Med Care 47:813-821. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA BACKGROUND: Many clinical and health services research studies are […]

Income inequities in end-of-life health care spending in British Columbia, Canada: A cross-sectional analysis, 2004-2006

Int J Equity Health 10:12. Centre for Health Services and Policy Research, University of British Columbia, Vancouver BC, Canada BACKGROUND: This study aimed to measure […]

Selection bias explains apparent differential mortality between dialysis modalities

Selection bias explains apparent differential mortality between dialysis modalities. J Am Soc Nephrol 22:1534-1542. University of Calgary, Calgary, AB, Canada The relative risk of death […]

Measuring data reliability for preventive services in electronic medical records

BMC Health Serv Res 12:116. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada BACKGROUND: Improvements in the quality of health care […]

Influence of chronic co-morbidity on health costs

Med Clin (Barc) 138:179-180. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials, Barcelona, Spain Launched in 1943, Medicina Clínica is a fortnightly journal aimed […]

Comparing measures of multimorbidity to predict outcomes in primary care: a cross sectional study

Fam Pract 30:172-178. Academic Unit of Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK BACKGROUND: An increasing proportion of people […]

Productivity and patient satisfaction in primary care — conflicting or compatible goals?

Health Policy 111:157-165. Lund University School of Economics and Management, Lund, Sweden Following recent reforms in Swedish primary care, providers are accountable to both citizens […]

Metformin use and all-cause and prostate cancer-specific mortality among men with diabetes

J Clin Oncol 31:3069-3075. Princess Margaret Hospital, University Health, Toronto, ON, Canada PURPOSE: To evaluate the association between cumulative duration of metformin use after prostate […]

Hospitalizations and emergency department use in Mayo Clinic Biobank participants within the employee and community health medical home

Mayo Clin Proc 88:963-969. Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA OBJECTIVE: To evaluate the participants in the […]

A model based on age, sex, and morbidity to explain variation in UK general practice prescribing: cohort study

BMJ 337:a238. Department of Statistical Science, University College London, London, UK OBJECTIVE: To examine whether patient level morbidity based measure of clinical case mix explains […]

Can gender difference in prescription drug use be explained by gender-related morbidity? A study on a Swedish population during 2006

BMC Public Health 14:329. Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden BACKGROUND: It has been reported […]

Long-term care benefits may reduce end-of-life medical care costs

Popul Health Manag Univita , Natick, MA, USA This study explores whether personal care services for functionally dependent or cognitively impaired individuals paid for by […]

Chapter 4: Effects of multimorbidity on healthcare resource use

In: Mercer SW, Salisbury C, Fortin M, ed. ABC of multimorbidity. Chichester, UK: Wiley:12-16. Haifa University, Haifa, Israel; Johns Hopkins University, Baltimore, MD, USA OVERVIEW […]

ACG-modell kan forutsaga vilka som blir hogkonsumenter av sjukvard

Lakartidningen: Published in Swedish. Health Department, Area Monitoring and Analysis , VästraGotaland, Sweden We describe a method, which uses already existent administrative data to identify […]

Understanding geographic variation in health care costs in British Columbia

Vancouver, BC, Canada: University of British Columbia (doctoral dissertation). University of British Columbia, Vancouver, BC, Canada Amidst concerns about escalating health spending, examining variation in […]

Strategies for assessing health plan performance on chronic diseases: selecting performance indicators and applying health-based risk adjustment

Hamilton, NJ, USA: Center for Health Care Strategies. University of Maryland, Baltimore County, and Johns Hopkins Bloomberg School of Public Health, USA As Medicaid managed […]

Burden of illness in defined populations

Stockholm, Sweden: Karolinska Institute. Karolinska Institute, Stockholm, Sweden This thesis addresses possibilities of describing the burden of illness in a population by elucidating morbidity and […]

Risk assessment of military populations to predict health care cost and utilization

Final report prepared for Center for Health Care Management Studies. RTI Project No. 08490.006. Washington, DC, USA: RTI International and Boston University School of Medicine. […]

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 […]

A comparative analysis of claims-based tools for health risk assessment

Schaumburg, IL, USA: Society of Actuaries. Japanese translation published by Tokyo Gakugei University. Society of Actuaries, Schaumburg, IL, USA This Society of Actuaries research project […]

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 […]

Managing the gap: evaluating the impact of Medicaid managed care on service use and disparities in health care access

Baltimore, MD, USA: University of Maryland (doctoral dissertation). University of Maryland, Baltimore, MD, USA The National Institutes of Health (NIH) define a health disparity as […]

Identifying patients with high pharmacy consumption by using the Adjusted Clinical Groups in a primary care setting

European Neuropsychopharmacology 19:S340-S341. Badalona Serveis Assistencials SA, Directorate ofPlanning, Badalona. Barcelona, Spain BACKGROUND: Prescription drug costs are rapidly increasing in most countries. The pharmaceutical expenditure […]

Plataforma de proces de dades d’atencio primaria

Barcelona, Spain: Universitat Politecnica de Catalunya (masters thesis). Published in Catalan. Universitat Politecnica de Catalunya, Spain No abstract

Measuring the casemix of physician practices in primary-care reform models in Ontario, Canada

BMC Health Serv Res 11:A22. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada INTRODUCTION: A number of different blended-payment models for primary- care delivery have […]

Patients with chronic illness in the patient-centered medical home: costs, use, quality and morbidity-based variation

Seattle, WA, USA: University of Washington (doctoral dissertation). University of Washington, Seattle, WA, USA Originally described in 1967 as a central source of a medical […]

Evaluation of the full service family practice incentive program and the practice support program: synthesis report for work completed to June 2013

Victoria, BC, Canada: Hollander Analytical Services Ltd. This report constitutes a synthesis of findings from the evaluation of the Full Service Family Practice Incentive Program […]

Kan casemix-systemer anvendes i den danske primaersektor?

Odense, Denmark: Syddansk Universitet. Published in Danish. Syddansk University, Odense, Denmark Dette arbejdspapir er udarbejdet af Forskningsenheden for Almen Praksis (FEA) og Center for Sundhedsøkonomisk […]

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