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Longitudinal costs and health service utilisation associated with primary care reforms in Ontario: a retrospective cohort study protocol

ABSTRACT Introduction Over the last 20 years, the Canadian province of Ontario implemented several new models of primary care focusing on changes to physician remuneration, […]

Readmissions Infographic

Preventing avoidable hospital readmissions is considered by many to be the most important opportunity for reducing waste in health care.  The Johns Hopkins ACG® System can […]

Defining and Assessing Geriatric Risk Factors and Associated Health Care Utilization Among Older Adults Using Claims and Electronic Health Records

Abstract Background: Using electronic health records (EHRs), in addition to claims, to systematically identify patients with factors associated with adverse outcomes (geriatric risk) among older […]

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Supporting Clinical Activities

The ACG System UK Team hosts a series of webinars aimed at providing an overview on a number of topics related to risk stratification, population […]

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Predictive Modelling in Action

An introduction to the principles of predictive modeling in health care and examples of how predictive models are being used in the NHS in England. Learn more.

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 […]

A cross-sectional, population-based study measuring comorbidity among people living with HIV in Ontario

BMC Public Health 14:161. Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON, Canada BACKGROUND: As people diagnosed with HIV and receiving combination antiretroviral […]

Health information exchange and the frequency of repeat medical imaging

Am J Manag Care 20:eSP16-24. Weill Cornell Medical College, New York, NY, USA OBJECTIVES: Medical imaging, which is expensive, is frequently repeated for the same […]

Missed strokes using computed tomography imaging in patients with vertigo: population-based cohort study

Stroke 46:108-113. University of Toronto, Toronto, ON, Canada; University Health Network, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada BACKGROUND AND PURPOSE: […]

The effect of pelvic fractures on future stress incontinence and pelvic organ prolapse surgery

Int Urogynecol J Western University, London, ON, Canad INTRODUCTION AND HYPOTHESIS: Pelvic fractures in women significantly disrupt the pelvic floor, which may cause stress urinary […]

Association between metformin use and mortality after cervical cancer in older women with diabetes

Cancer Epidemiol Biomarkers Prev 25:507-512. University Health Network, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Women’s College Hospital, Toronto, ON, Canada; Institute of […]

Effect of specialized diagnostic assessment units on the time to diagnosis in screen-detected breast cancer patients

Br J Cancer 112:1744-1750. Queen’s University, 10 Stuart Street, Kingston, ON, Canada; Cancer Care Ontario, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; University […]

Is the association between physical activity and healthcare utilization affected by self-rated health and socio-economic factors?

BMC Public Health 15:737. Lund University, Malmö, Sweden BACKGROUND: Physical activity and healthcare utilization has negative association. However, there appears to be limited knowledge of […]

Full-service family practice in British Columbia: policy interventions and trends in practice, 1991-2010

Healthc Policy 9:32-47. University of British Columbia Vancouver, BC, Canada BACKGROUND: British Columbia’s primary care reform (initiated in 2002) aims to promote “full-service family practice” […]

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 […]

Patient ability and willingness to participate in a web-based intervention to improve hypertension control.

J Med Internet Res 13:e1. Group Health Research Institute, Seattle, WA, USA BACKGROUND: Patient-shared electronic health records provide opportunities for care outside of office visits. […]

Measures of multimorbidity and morbidity burden for use in primary care and community settings: a systematic review and guide

Ann Fam Med 10:134-141. Academic Unit of Primary Health Care, School of Social and Community Medicine, Bristol University, Bristol, UK PURPOSE: Many patients consulting in […]

Development of a risk-adjusted capitation model based on principal inpatient diagnoses in Taiwan

J Formos Med Assoc 102:637-643. Graduate Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan BACKGROUND AND PURPOSE: Taiwan’s […]

Use of proton pump inhibitors and risk of osteoporosis-related fractures

CMAJ 179:319-326. Department of Gastroenterology, Division of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada BACKGROUND: The use of proton pump inhibitors has been associated […]

Formal risk adjustment by private employers

Inquiry 38:299-309. Department of Economics, Boston University, Boston, MA, USA This paper explores explanations for why few private employers have adopted formal risk adjustment. The […]

Patient use of secure electronic messaging within a shared medical record: a cross-sectional study

J Gen Intern Med 24:349-355. Group Health Cooperative, Center for Health Studies, Seattle, WA, USA BACKGROUND: Most patients would like to be able to exchange […]

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 […]

Effect of premium, copayments, and health status on the choice of health plans

Med Care 46:1033-1040. Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA OBJECTIVE: Explore effects of comorbidity […]

Patient sharing among physicians and costs of care: a network analytic approach to care coordination using claims data

J Gen Intern Med 28:459-465. Johns Hopkins University School of Medicine, Baltimore, MD, USA BACKGROUND: Improving care coordination is a national priority and a key […]

Case-mix index and length of hospitalization

G Chir 31:211-214. Published in Italian. Department of Surgical Sciences, Sapienza University of Rome, Italy. The ACG (Adjusted Clinical Groups) case-mix system is a classification […]

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 […]

Realigning incentives in fee-for-service Medicare

Health Aff 22:59-70. Schneider Institute for Health Policy, Brandeis University, Waltham, MA, USA This paper proposes Medicare payment reform built on the fee-for-service system, with […]

Work limitations and their relationship to morbidity burden among academic health center employees with diabetes

Workplace Health Saf 60:425-434. Department of Acute and Chronic Care, John Hopkins University School of Nursing, Baltimore, MD, USA The objective of this study was […]

Population-based trends in osteoporosis management after new initiations of long-term systemic glucocorticoids (1998-2008)

J Clin Endocrinol Metab 97:1236-1242. University of Alberta and University of Alberta Hospital, Edmonton, AB, Canada OBJECTIVES: Our objective was to describe changes in glucocorticoid-induced […]

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

Racial and ethnic differences in utilization of health services in patients with diabetes enrolled in Medicaid

J Health Care Poor Underserved 15:562-575. General Internal Medicine and Health Services Research, UCLA School of Medicine, Los Angeles, CA, USA. We evaluated racial and […]

The effect of acupuncture utilization on healthcare utilization

Med Care 46:41-48. Department of Pharmacy Practice, Albany College of Pharmacy, Research Institute for Health Outcomes, Albany, NY, USA OBJECTIVE: To determine whether acupuncture is […]

A systematic review of health care efficiency measures

Health Serv Res 44:784-805. RAND, Arlington, VA, USA OBJECTIVE: To review and characterize existing health care efficiency measures in order to facilitate a common understanding […]

Achieving cost control, care coordination, and quality improvement in the Medicaid program

J Ambul Care Manage 33:38-49; discussion 69-70. ACS Government Healthcare Solutions, Helena, MT, USA As Medicaid spending rises quickly, controlling cost while coordinating care and […]

Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study

J Bone Miner Res 26:2762-2769. Bone Disease Unit, University of Lausanne, Lausanne, Switzerland The measurement of BMD by dual-energy X-ray absorptiometry (DXA) is the “gold […]

Two-year trends in colorectal cancer screening after switch to a high-deductible health plan

Med Care 49:865-871. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA BACKGROUND: Recent health reform laws might […]

Postoperative health-care utilization in Crohn’s disease: the impact of specialist care

Am J Gastroenterol 107:1522-1529. Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, Toronto, ON, Canad OBJECTIVES: Crohn’s disease (CD) patients frequently require […]

How does complementary private prescription drug insurance coverage affect seniors’ use of publicly funded medications?

Health Policy 110:147-155. School of Public Policy and Governance, University of Toronto, Toronto, ON, Canada BACKGROUND: Like in many other high-income jurisdictions, the public drug […]

Division of primary care services between physicians, physician assistants, and nurse practitioners for older patients with diabetes

Med Care Res Rev 70:531-541. University of Wisconsin–Madison, WI, USA; University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA Team-based care involving physician assistants and/or […]

Resources allocation and health care needs in diabetes care in Danish GP clinics

Health Policy 113:206-215. Institute of Public Health, Centre of Health Economics Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark BACKGROUND: In several […]

Measuring medical productivity to gauge the value of Medicare

Minn Med 96:46-48. Department of Finance, Medical Industry Leadership Institute, Carlson School of Management, University of Minnesota, Minneapolis, MN, USA. Having a measure of productivity […]

The effect of medical malpractice liability on rate of referrals received by specialist physicians

Health Econ Policy Law 8:453-475. Yale University School of Medicine, New Haven, CT, USA; Wayne State University, Detroit, MI, USA; University of Michigan, School of […]

Determinants of buprenorphine treatment for opioid dependence

J Subst Abuse Treat 46:315-319. Washington State University, Spokane, WA, USA; Group Health Research Institute, Seattle, WA, USA This study assessed the social, demographic and […]

How is the electronic health record being used? Use of EHR data to assess physician-level variability in technology use

J Am Med Inform Assoc Weill Cornell Medical College, New York, NY, USA BACKGROUND: Studies of the effects of electronic health records (EHRs) have had […]

Procedures take less time at ambulatory surgery centers, keeping costs down and ability to meet demand up

Health Aff 33:764-769. University of Louisville, Louisville, KY, USA; University of Minnesota, Minneapolis, MN, USA During the past thirty years outpatient surgery has become an […]

The association between parental depression and children’s health care utilization and expenditures: exploring the dimensions of parental gender and timing of depressive symptoms

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, USA Methods: The study used multiple […]

A descriptive analysis of the Ontario MedsCheck annual pharmacy medication review service

Canadian Pharmacists Journal 148:S27. OBJECTIVES: A MedsCheck Annual (MCA) consultation is a medication review service funded by the Ontario government for people taking three or […]

Associations among socioeconomic status (SES), patterns of care and outcomes in breast cancer (BC) patients (pts) in a universal health care system: Ontario’s experience

2014 American Society of Clinical Oncology Annual Meeting. Abstract 6625. J Clin Oncol 32 (suppl; abstr 6625). University of Toronto, Toronto, ON, Canada; Sunnybrook Health […]

The impact of not having a primary care physician among people with chronic conditions

Toronto, ON, Canada: Institute for Clinical Evaluative Sciences. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada BACKGROUND: Primary care plays a pivotal role in health […]

Using the Adjusted Clinical Groups System to identify high-risk hemodialysis patients in Taiwan

J Healthc Manag 11:311-326. Published in Chinese. OBJECTIVES: There has been a rising number and cost of patients with regular hemodialysis in Taiwan. The objective […]

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) […]

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 […]

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 […]

An operational framework for paying physician specialists a risk-adjusted fixed payment and incorporating the results in a global premium rating model

Los Angeles, CA, USA: UCLA (doctoral dissertation). University of California, Los Angeles, CA, USA The demand for more accurate and equitable professional medical specialty payments […]

Characteristics and utilization patterns of high-cost recipients in Medicaid population

MEDTAP 2001-2003 Research Project #1. Cincinnati, OH, USA: University of Cincinnati and Institute for Health Policy and Health Services Research. University of Cincinnati and Institute […]

Adjusting for patients’ clinical case mix explains variation in general practice prescribing

Research report no. 291, Department of Statistical Science. London, UK: University College London. University College London, London, UK BACKGROUND: The potential of using patient-level measures […]

Investigating whether the Johns Hopkins ACG case-mix system explains variation in UK general practice

London, UK: University College London (doctoral dissertation). University College London, London, UK This thesis describes the first large-scale studies in the United Kingdom to adjust […]

Familial aggregation of childhood health and the socioeconomic gradient of disease: a longitudinal population-based sibling analysis

Winnipeg, MB, Canada: University of Manitoba (masters thesis). University of Manitoba, Winnipeg, MB, Canada The Johns Hopkins ACG(r) Case-Mix System grouped various physician and hospital […]

Impact of rheumatoid arthritis on recognition of hypertension in a medically homed population

Arthritis Rheum 64:S712-S713. University of Wisconsin, Madison, WI, USA BACKGROUND/PURPOSE: Numerous studies report increased cardiovascular disease (CVD) events and others describe increased arterial stiffness in […]

Adjusted Clinical Groups (ACG) and co-morbidity

ImPrim Report D. Karlskrona, Sweden: ImPrim. Blekinge Centre of Competence, Karlskrona, Sweden No abstract

Depression, anxiety disorders, and related health care utilization in the Manitoba Metis population

Winnipeg, MB, Canada: Manitoba Metis Federation. Manitoba Metis Federation, Winnipeg, MB, Canada This report resulted from the need to understand further the findings in the […]

Leicester City CCG Case Study 3

Use of ACG® System output to support distribution of CCG Better Care Fund monies

Resource Allocation Case Study-Government

Sweden became one of the first international adopters of the Johns Hopkins ACG System in the mid 1990s and has expanded its use to cover […]

Poster: Morbidity Burden Resource Use and Quality of Care of Diabetic Patients

Morbidity burden, resource use and quality of care of diabetic patients: A 4-year cohort analysis at a regional hospital in Thailand. Roongkarn Pannarunothai, Buddhachinaraj Hospital, […]

Embedding ACGs in Berkshire

NHS Berkshire Embedding ACGs in Berkshire Karen Grannum Primary Care Business Intelligence Lead

Using the ACG Toolkit to Support Population Monitoring

DST Health Solutions Using the ACG Toolkit to Support Population Monitoring Lisa Kabasakalian

Monday(C3)-Identifying Potentially Actionable Chronic Disease Patterns From Diagnoses Reported in Administrative Claims-Dave Bodycombe

Identifying Potentially Actionable Chronic Disease Patterns From Diagnoses Reported in Administrative Claims —Dave Bodycombe, Johns Hopkins University

Tuesday(C8)- Use of ACG within Benefit Informatics for employer health plan cost management-Bruns

 Use of ACG within Benefit Informatics for employer health plan cost management-Bruns Benefit Focus

THE INTEGRATION OF ACG WITH THE BUSINESS INTELLIGENCE SYSTEM OF A LOCAL HEALTH UNIT IN VENETO REGION, ITALY 

N. Alba1, C. Bovo1, R. Marchi1, R. Borin1, F. Avossa2, E. Schievano2, M. Saugo2, M.C. Corti3, E. Boscolo3, C. Abrams4, K. Kinder4, D. Mantoan3;  1Local […]

ICD-10: Kelsey Rauch, DST Health Solutions

ACG System DST Health Solutions The Impact of Transitioning Coding Systems on Risk Adjustment Kelsey Rauch

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Various ACG System Applications

Amy Salls, Director of Population Health Strategy at DST Health Solutions, provides a summary on the commercialization process and the various populations, applications, and user needs that the ACG System helps in the United States. Learn More.

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Population Segmentation Case Study – Payer

Johns Hopkins Healthcare (JHHC) develops and manages medical care contracts for close to 400,000 plan members. JHHC created a framework based on an adapted version of the National Academy of Medicine taxonomy, combined with ACG System output, to provide a more extensive set of risk categories in an effort to expand their care management programs to high-risk Medicare patients.

Outcomes Among Patients Discharged From the Emergency Department With a Diagnosis of Peripheral Vertigo

Objective: We aimed to determine the risk of short- and long-term stroke, as well as accidental injury, in patients discharged from an emergency department who […]

Evaluating the Impact of Prescription Fill Rates on Risk Stratification Model Performance

Risk adjustment models are traditionally derived from administrative claims. Prescription fill rates—extracted by comparing electronic health record prescriptions and pharmacy claims fills —represent a novel […]

First Use of a Population Health Management Strategy in Dutch Primary Health Care

Abstract Introduction: Recently, in Dutch health care the focus is shifting from a disease oriented approach to a more population based approach. Since in The […]

Impactibility Model for Population Health Management in High-Cost Elderly Heart Failure Patients: A Capture Method Using the ACG System

Abstract The aim of the present study is to use the ACG (Adjusted Clinical Groups) System to create an impactibility model by identifying homogeneous clinical […]

The Value of Unstructured Electronic Health Record Data in Geriatric Syndrome Case Identification

Abstract Objectives To examine the value of unstructured electronic health record (EHR) data (free‐text notes) in identifying a set of geriatric syndromes. Design Retrospective analysis […]

A Multi-sourced Data Analytics Approach to Measuring and Assessing Biopsychosocial Complexity: The Vancouver Community Analytics Tool Complexity Module (VCAT-CM)

Abstract Operationalization of the fundamental building blocks of primary care (i.e. empanelment, team-based care and population management) within the context of Community Health Centers requires […]

Effectiveness and Safety of Inhaled Corticosteroids in Older Individuals with Chronic Obstructive Pulmonary Disease and/or Asthma. A Population Study

Abstract Rationale Inhaled corticosteroids (ICS) are established medications for the management of both asthma and chronic obstructive pulmonary disease (COPD), two common chronic airway diseases. […]

Symptom burden among head and neck cancer patients in the first year after diagnosis: Association with primary treatment modality

Abstract Purpose Head and neck cancer (HNC) and its treatment affects quality of life, with significant symptom burden. The main objectives of this study were […]

Trends in cardiovascular care and event rates among First Nations and other people with diabetes in Ontario, Canada, 1996–2015

Abstract Background Rates of cardiovascular disease among people with diabetes have declined over the last 20–30 years. To determine whether First Nations people have experienced […]

Temporal condition pattern mining in large, sparse electronic health record data: A case study in characterizing pediatric asthma

Abstract Objective This study introduces a temporal condition pattern mining methodology to address the sparse nature of coded condition concept utilization in electronic health record […]

Assessing the geographical distribution of comorbidity among commercially insured individuals in South Africa

Abstract Background Comorbidities are strong predictors of current and future healthcare needs and costs; however, comorbidities are not evenly distributed geographically. A growing need has […]

A population-based study comparing outcomes for patients with metastatic castrate resistant prostate cancer treated by urologists or medical oncologists with first line abiraterone acetate or enzalutamide

Abstract Objectives To compare toxicity and all-cause mortality for mCRPC patients receiving first line oral systemic therapy prescribed by medical oncologists and urologists. Methods Population-based […]

Accidental injury, self‐injury, and assault among children of women with schizophrenia: a population‐based cohort study

Abstract Objective We aimed to compare the risk for injury overall and by intent (accidental injury, self‐injury, and assault) among children born to women with […]

Development and validation of the Cambridge Multimorbidity Score

Abstract BACKGROUND Health services have failed to respond to the pressures of multimorbidity. Improved measures of multimorbidity are needed for conducting research, planning services and […]

Frailty is highly prevalent in specific cardiovascular diseases and females, but significantly worsens prognosis in all affected patients: A systematic review

Abstract Objective Cardiologists are more often confronted with older (>60 years) cardiovascular disease (CVD) patients. These patients have particular needs in clinical care because, for […]

Multimorbidity and chronic diseases among undocumented migrants: evidence to contradict the myths

Abstract Background There is little verified information on the global health status of undocumented migrants (UMs). Our aim is to compare the prevalence of the […]

Impact of Neighborhood Social and Environmental Resources on Medicaid Spending

Abstract Introduction In an era of COVID-19, Black Lives Matter, and unsustainable healthcare spending, efforts to address the root causes of health are urgently needed. […]

Development of measurable criteria to identify and prioritize patients for inclusion in comprehensive medication management programs within primary care settings

ABSTRACT BACKGROUND Pharmacists optimize medication use and ensure the safe and effective delivery of pharmacotherapy to patients using comprehensive medication management (CMM). Identifying and prioritizing […]

Emergency department use and hospital admission in children following ambulatory surgery: a retrospective population-based cohort study

ABSTRACT Introduction Paediatric ambulatory surgery (same day surgery and planned same day discharge) is more frequently being performed more in Canada and around the world; […]

Opioid Use after Nephrectomy for Kidney Cancer in Ontario: A Population-Based Study

Abstract Objective To compare the odds of early and prolonged post-operative opioid use in patients undergoing minimally invasive surgery (MIS) versus open surgery for nephrectomy. […]

Evaluating the predictive value of comorbidity indices in pituitary surgery: a mixed-effects modeling study using the Nationwide Readmissions Database

Abstract OBJECTIVE Although pituitary adenomas (PAs) are common intracranial tumors, literature evaluating the utility of comorbidity indices for predicting postoperative complications in patients undergoing pituitary […]

Using the Johns Hopkins ACG Case-Mix System for population segmentation in a hospital-based adult patient population in Singapore

Abstract Objective Population health management involves risk characterisation and patient segmentation. Almost all population segmentation tools require comprehensive health information spanning the full care continuum. […]

Population risk stratification tools and interventions for chronic disease management in primary care: a systematic literature review

Abstract Background Population risk stratification (RS) tools have been proposed to tailor interventions, prioritize resources, and proactively manage high-risk individuals with chronic diseases in primary […]

Enhancing Depression Identification and Stratification with a Claims-Based Analytical Framework

Abstract Depression, a prevalent health condition, substantially impacts both socioeconomic outcomes and individual wellbeing. Despite the availability of diagnostic tools, existing approaches for identifying depression […]