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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 […]

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 […]

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 […]

Population-based Study of the Effect of Free Influenza Vaccination on Medical Utilization of Elderly

National Yang Ming University A Population-based Study of the Effect of Free Influenza Vaccination on Medical Utilization of Elderly Taiwanese Ching Wen Chien, Ph.D.

Population risk stratification to support strategic planning and commissioning

NHS Midlands and Lancashire Commissioning Support Unit Population Level Risk Stratification to Support Strategic Planning and Commissioning  

Wednesday(C9)-The Creation of New Models to Predict Future Resource Use and Risk of Hospital Admission for a General Population in NHS England —Stephen Sutch

The Creation of New Models to Predict Future Resource Use and Risk of Hospital Admission for a General Population in NHS England —Stephen Sutch, Johns […]

Tuesday(C7)-Development of the case finding tool using the ACG system-Roberts

Development of the case finding tool using the ACG system Kevin Roberts

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Readmissions: What Health Plans Need to Know

Preventing avoidable hospital readmissions is considered by many to be the most important opportunity for reducing waste in health care. This podcast explains readmissions and why identifying these at-risk patients is important to health plans. Learn more.

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Case Mix Adjustment Case Study – Payer

This Case Study shows how Leicester City CCG, one of the most ethnically diverse areas of the UK, analyzed emergency admission rates for all practices, to learn that practices with lower emergency admission rates had significantly higher coding completeness and GP patient survey scores. Learn more.

High-Density Lipoprotein Cholesterol and Cause-Specific Mortality in Individuals Without Previous Cardiovascular Conditions

BACKGROUND The prognostic importance of high-density lipoprotein cholesterol (HDL-C) as a specific risk factor for cardiovascular (CV) disease has been challenged by recent clinical trials […]

Case Study: Johns Hopkins Community Health Partnership: A model for transformation

Abstract To address the challenging health care needs of the population served by an urban academic medical center, we developed the Johns Hopkins Community Health […]

Evidence on multimorbidity from definition to intervention: An overview of systematic reviews

Abstract The increasing challenge of multiple chronic diseases (multimorbidity) requires more evidence-based knowledge and effective practice. In order to better understand the existing evidence on […]

Parenchymal hyperdensity on C-arm CT images after endovascular therapy for acute ischaemic stroke predicts a poor prognosis

ABSTRACT   AIM To investigate whether hyperdense areas (HDAs) observed after endovascular treatment on multisection computed tomography (CT) are related to outcome. MATERIALS AND METHODS Data on […]

Emergency Department Use: Common Presenting Issues and Continuity of Care for Individuals With and Without Intellectual and Developmental Disabilities

Abstract This population-based cohort study examined the relationship between level of continuity of primary care and subsequent emergency department (ED) visits for adults with (n = 66,484) […]

Prediction Accuracy With Electronic Medical Records Versus Administrative Claims

Abstract Objective:  The objective of this study was to evaluate the incremental predictive power of electronic medical record (EMR) data, relative to the information available […]

Population segmentation based on healthcare needs: a systematic review

Abstract Background Healthcare needs-based population segmentation is a promising approach for enabling the development and evaluation of integrated healthcare service models that meet healthcare needs. […]

Incidence of Hospitalizations and Emergency Department Visits for Herpes Zoster in Immunocompromised and Immunocompetent Adults in Ontario, Canada, 2002-2016

Abstract BACKGROUND Immunocompromised adults are at increased risk of herpes zoster (HZ) infection and related complications. We aimed to assess the incidence of hospital-attended HZ […]

Association Between Dysphagia and Inpatient Outcomes Across Frailty Level Among Patients ≥ 50 Years of Age

Abstract Frail patients may have heightened risk of dysphagia, a potentially modifiable health factor. Our aim is to examine whether the relationship between dysphagia and […]

Multimorbidity as a predictor of health service utilization in primary care: a registry-based study of the Catalan population

Abstract Background Multimorbidity is highly relevant for both service commissioning and clinical decision-making. Optimization of variables assessing multimorbidity in order to enhance chronic care management […]

Looking across health and healthcare outcomes for people with intellectual and developmental disabilities and psychiatric disorders: population-based longitudinal study

Abstract Background Intellectual and developmental disabilities (IDDs) and psychiatric disorders frequently co-occur. Although each has been associated with negative outcomes, their combined effect has rarely […]

Trends in prevalence of chronic disease and multimorbidity in Ontario, Canada

Abstract BACKGROUND New case-mix tools from the Canadian Institute for Health Information offer a novel way of exploring the prevalence of chronic disease and multimorbidity […]

Assessing the Population-Level Correlation of Medication Regimen Complexity and Adherence Indices Using Electronic Health Records and Insurance Claims

Abstract BACKGROUND Nonadherence to medication regimens can lead to adverse health care outcomes and increasing costs. OBJECTIVES To (a) assess the level of medication complexity […]

Direct cost of Parkinson’s disease in a health system with high judicialization: evidence from Colombia

Abstract Objective To estimate all-claims-all-conditions expenditures paid for by health plans for patients suffering from Parkinson´s disease (PD). Methods Using administrative claims data from two […]

Partial nephrectomy in frail patients: Benefits of robot-assisted surgery

Abstract Background To compare the effect of robot-assisted (RAPN) vs. open (OPN) partial nephrectomy on short-term postoperative outcomes and total hospital charges in frail patients […]

Controller Medication Use and Exacerbations for Children and Adults With Asthma in High-Deductible Health Plans

Abstract Importance High-deductible health plans (HDHPs) are increasingly common and associated with decreased medication use in some adult populations. How children are affected is less […]

How long does it take patients to find a new primary care physician when theirs retires: a population-based, longitudinal study

Abstract Background The retirement of a family physician can represent a challenge in accessibility and continuity of care for patients. In this population-based, longitudinal cohort […]

High prevalence of comorbidities at diagnosis in immigrants with multiple sclerosis

Abstract Background Multiple sclerosis (MS) has been associated with certain comorbidities in general population studies, but it is unknown how comorbidity may affect immigrants with […]

Primary Care Continuity andWait Times to Receiving Breast Cancer Chemotherapy: A Population-Based Retrospective Cohort Study Using CanIMPACT Data

Abstract Background Wait times to chemotherapy are associated with morbidity and mortality in breast cancer patients; however, it is unclear how primary care physician (PCP) continuity […]

Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes

Abstract Objective To determine the association between directly measured physical activity and hospitalisation, intensive care unit (ICU) admission, ventilation and mortality rates in patients with […]

Matching Special Olympics registration data with administrative health databases: Feasibility and health status differences in children and youth with IDD

Abstract Background Children and youth with intellectual and developmental disabilities (IDD) experience health disparities. What is unknown is if data collected from children and youth […]

Association Between Frailty, 30-day Unplanned Readmission and Mortality After Hospitalization for Heart Failure: Results From the Nationwide Readmissions Database

Abstract Objectives: This study examined how frailty in traditional risk-adjusted models could improve the predictability of unplanned 30-day readmission and mortality among heart failure patients. […]

Medicare telehealth utilization by Rural Health Clinics and Federally Qualified Health Centers prior to and during the COVID-19 pandemic

Abstract Purpose To address the extent to which Federally Qualified Health Centers (FQHCs) and independent and provider-based Rural Health Clinics (RHCs) were using telehealth prior […]

Risk Stratification Methods, Use Cases, and Lessons Learned

To deliver on the promise of high-quality, value-based care for our patients in the context of workforce shortages and an aging population, risk stratification is […]

NHS Leicester, Leicestershire and Rutland ICB Health Equity Payments Evaluation

Background The Health Equity Payment (HEP) scheme was developed by population health leads from NHS Leicester, Leicestershire and Rutland (LLR) Integrated Care Board (ICB), intended […]

Social Determinants of Health and 30-Day Mortality After Inpatient Elective Surgery

Abstract Importance Prior research conducted in private for-profit health care systems has suggested that social determinants of health (SDOH) play a role in adverse postoperative […]

Measuring the relationship between outpatient family physician visit regularity and acute care utilization during the end of life: a population-level retrospective cohort study

Abstract Background Family physicians (FP) are critical in providing outpatient end-of-life (EOL) care, yet most continuity measures do not consider temporal changes in visits. The […]

Risk of Incident Cardiovascular Events Following Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy

Abstract Objective: To compare the risk of incident cardiovascular disease (CVD) events following sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). Background: Bariatric surgery is […]

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 […]

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Case Management and Care Coordination Part 1

This webinar will provide an overview of the data available within the ACG System to support case finding activities. The topics covered will include the […]

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Case Mix Adjustment in Primary Care

Presented by: Dr. David Shepherd FRCGP

This webinar shares a case study of Leicester CCG in the UK. The ACG System was used to analyze emergency admission rates for all practices in the area. The top 8 practices were identified and studied further to understand key characteristics of those practices.

Developing a dashboard to help measure and achieve the triple aim: a population-based cohort study

BMC Health Serv Res 14:363. McMaster University, Hamilton, ON, Canada BACKGROUND: Health system planners aim to pursue the three goals of Triple Aim: 1) reduce […]

Performance of the ACG case-mix system in two Canadian provinces.

Med Care 39:86-99. Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada BACKGROUND: While the adjusted clinical group (ACG) system […]

Identifying possible indicators of systematic overuse of health care procedures with claims data

Med Care 52:157-163. Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, USA BACKGROUND: Health care quality is frequently described with measures representing […]

Evaluating diagnosis-based case-mix measures: how well do they apply to the VA population?

Med Care 39:692-704. Center for Health Quality, Outcomes and Economic Research, Bedford VAMC, MA, USA BACKGROUND: Diagnosis-based case-mix measures are increasingly used for provider profiling, […]

The association between continuity of care and the overuse of medical procedures

JAMA Intern Med Johns Hopkins University, Baltimore, MD, USA Importance: Both the overuse of unnecessary medical procedures and poor continuity of care are thought to […]

Effect of attribution length on the use and cost of health care for a pediatric Medicaid Accountable Care Organization

JAMA Pediatr 170:148-154. Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN, USA IMPORTANCE: Little is known about the effect of pediatric accountable care organizations (ACOs) […]

Factors associated with acute care use among nursing home residents dying of cancer: a population-based study

Int J Palliat Nurs 21:349-356. McMaster University, Hamilton, ON, Canada BACKGROUND: Little is known about residents of long-term care (LTC) facilities who die of cancer. […]

Predictors of opioid-related death during methadone therapy

J Subst Abuse Treat 57:30-35. University of Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; St. Michael’s Hospital, Toronto, ON, Canada; St. […]

The potential for community-based health information exchange systems to reduce hospital readmissions

J Am Med Inform Assoc 22:435-442. Weill Cornell Medical College, New York, NY, USA BACKGROUND: Hospital readmissions are common, costly, and offer opportunities for utilization […]

Fifty years of pediatric asthma in developed countries: how reliable are the basic data sources?

Pediatr Pulmonol 47:211-219. British Columbia’s Children’s Hospital, Vancouver, BC, Canada Given the difficulties in diagnosing, or even defining, asthma in children, claims of a pediatric […]

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 […]

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 […]

Biphasic fracture risk in diabetes: a population-based study

Bone 40:1595-1601. Department of Medicine, University of Manitoba, Winnipeg, MB, Canada Diabetes is associated with increased fracture rates but the effect size, time course and […]

The comorbidity burden of the treated asthma patient population in British Columbia

Chronic Dis Can 30:46-55. University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, BC, Canada To date there has been little investigation of the prevalence […]

Nonparticipation in a population-based trial to increase colorectal cancer screening

Am J Prev Med 42:390-397. Group Health Permanente, University of Washington Medical School, Seattle, WA, USA BACKGROUND: Many trials have tested different strategies to increase […]

Institutionalization following incident non-traumatic fractures in community-dwelling men and women

Osteoporos Int 23:2381-2386. Division of General Internal Medicine, McGill University Health Center, Montreal, QC, Canada Institutionalization after hip fracture occurs in at least 30% of […]

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 […]

Mortality rates after incident non-traumatic fractures in older men and women.

Osteoporos Int 22:2439-2448. Division of General Internal Medicine, McGill University Health Center, Montreal, QC, Canada Non-traumatic fractures at typical osteoporotic sites are associated with increased […]

Comorbidity patterns in patients with chronic diseases in general practice

PLoS One 7:e32141. Multiprofessional Education Unit for Family and Community Care (Southwest), Madrid, Spain INTRODUCTION: Healthcare management is oriented toward single diseases, yet multimorbidity is […]

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 […]

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 […]

Morbidity and older persons’ perceptions of the quality of their primary care

J Am Geriatr Soc 54:330-334. Department of Health Policy and Management, Bloomberg School of Public Health, School of Medicine, Johns Hopkins University, Baltimore, MD, USA […]

Primary care physicians’ experiences with case finding for practice-based care management

Am J Manag Care 18:e155-161. Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany. OBJECTIVES: The identification of patients most likely […]

A population-based analysis of the clinical course of 10,304 patients with acute cholecystitis, discharged without cholecystectomy

J Trauma Acute Care Surg 74:26-30; discussion 30-1. Li Ka Shing Knowledge Institute, St Michael’s Hospital; and Institute for Clinical Evaluative Science, Toronto, ON, Canada […]

Self-referral in point-of-service health plans

JAMA 285:2223-2231. Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA CONTEXT: Most health maintenance organizations offer […]

Cost and quality trends in direct contracting arrangements

Health Aff 21:89-102. Health Systems Management Faculty, School of Public Affairs, University of Baltimore, Baltimore, MD, USA. This paper presents the first empirical analysis of […]

Impact of open-access scheduling on realized access

Health Serv Manage Res 20:134-139. Department of Family Medicine, Mayo Clinic, Rochester, MN, USA Open-access or advanced-access scheduling, which opens the clinic calendar to patients […]

Influence of morbidity and the use of health resources in patients who require care for generalised anxiety disorder in the primary health care setting

Aten Primaria 40:603-610. Published in Spanish. Dirección de Planificación. Badalona Serveis Assistencials, S.A. Badalona. Barcelona, Spain OBJECTIVE: To evaluate the co-morbidity, health care use, economical […]

Patterns in the use of benzodiazepines in British Columbia: examining the impact of increasing research and guideline cautions against long-term use

Health Policy 97:122-129. Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada OBJECTIVE: We examined changes in patterns of benzodiazepine […]

Who cares for Medicaid-enrolled children with chronic conditions?

Pediatrics 108:906-912. Center for Child and Adolescent Health Policy, MassGeneral Hospital for Children, Boston, MA, USA OBJECTIVE: To estimate generalist, pediatric subspecialist, and any subspecialist […]

Predicting the risk of 1-year mortality in incident dialysis patients: accounting for case-mix severity in studies using administrative data

Med Care 49:257-266. Faculty of Medicine, University of Calgary, Calgary, AB, Canada BACKGROUND: Administrative databases are increasingly being used to study the incident dialysis population […]

Tracking family medicine graduates. Where do they go, what services do they provide and whom do they see?

BMC Fam Pract 13:26. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada BACKGROUND: There are continued concerns over an adequate supply […]

Cost analysis of adding pregabalin or gabapentin to the management of community-treated patients with peripheral neuropathic pain

J Eval Clin Pract 18:1170-1179. Badalona Serveis Assistencials, Badalona, Barcelona, Spain OBJECTIVE: To compare the cost of adding either pregabalin or gabapentin to the management […]

A new simple primary care morbidity score predicted mortality and better explains between practice variations than the Charlson index

J Clin Epidemiol 66:436-444. Population Health Research Centre, Division of Population Health Sciences and Education, St George’s University of London, London, UK OBJECTIVES: Adjustment for […]

Doctor shopping by overweight and obese patients is associated with increased healthcare utilization

Obesity 21:1328-1334. Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. OBJECTIVE: Negative interactions with healthcare providers […]

Patient poverty and workload in primary care: study of prescription drug benefit recipients in community health centres

Can Fam Physician 59:384-390. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON, Canada Erratum in: Can Fam Physician. 2013 Jun;59(6):612. OBJECTIVE: To […]

Adverse events recorded in English primary care: observational study using the General Practice Research Database

Br J Gen Pract 63:534-542. Department of Primary Care and Public Health (DPCPH), Imperial College London, London, UK BACKGROUND: More accurate and recent estimates of […]

The roles of primary care PAs and NPs caring for older adults with diabetes

JAAPA 27:45-49. Duke University School of Medicine, Durham, NC; Veterans Affairs Pittsburgh Healthcare System and University of Pittsburgh School of Pharmacy, Pittsburgh, PA; University of […]

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 […]

Evaluating case-mix and predictive modeling measures within the British primary care sector

BMC Health Serv Res 7:A8. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Imperial College London, UK Aim: The goal of this project […]

Clinical analytics and data management for the DNP

New York, NY, USA: Springer. Johns Hopkins Health Care, Glen Burnie, MD, USA Strong data management knowledge and skills are a requirement for every DNP. […]

Using case finding and risk stratification: a key service component for personalised care and support planning

London, UK: National Health Service. National Health Service. London, UK This handbook describes current thinking and provides practitioner insights into case finding and risk stratification […]

Population profiling in Slough CCG

Windsor, UK: NHS Slough Clinical Commissioning Group. NHS Slough Clinical Commissioning Group, Windsor, UK As our population ages and the prevalence of long term conditions […]

Editorial: Managing costs with software. Advance for Health Information Executives

Advance Newsmagazines, King of Prussia, PA, USA More than two years ago when Dave Ford took over as CEO at CareOregon in Portland, Ore., the […]