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2026 ACG User Summit
September 20 – 22 | Orlando, FL
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Center for Health Program Development and Management, University of Maryland, Baltimore County, and Actuarial Research Corporation

A guide to implementing a health-based risk-adjusted payment system for Medicaid managed care programs. Annandale, VA, USA: Center for Health Program Development and Management, University […]

Pharmaceutical use in Manitoba: opportunities to optimize use

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada This report provides a snapshot of […]

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, […]

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 […]

L’utilisation des services de sante par les Montrealais atteings de diabete, annees 2001-2002 a 2009-2010

Montreal, QC, Canada: Montreal Health and Social Services Agency. Montreal Health and Social Services Agency, Montreal, QC, Canada No abstract

Evaluation of diagnosis-based risk adjustment among specific subgroups: can existing adjusters be improved by simple modifications?

Health Serv Outcomes Res Methodology 3:57-73. Academic Technology Center, Bentley College, Waltham, MA, USA; Center for Health Quality, Outcomes and Economic Research, Veterans Administration Medical […]

Evaluation of alternative diagnosis based risk adjustment models and morbidity trajectories for application in Taiwan

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, USA OBJECTIVE: The overall goals of […]

Hospitalizations for ambulatory care sensitive conditions among persons with an intellectual disability,

Manitoba, 1999-2003. Toronto, ON, Canada: University of Toronto (doctoral dissertation). University of Toronto, Toronto, ON, Canada This thesis examines hospitalizations for ambulatory care sensitive conditions […]

Nursing home adverse events: further insight into highest risk periods

Journal of the American Medical Directors Association 12:467-474. University of Manitoba, Winnipeg, MB, Canada INTRODUCTION: Adverse events (AEs) occur frequently in nursing homes (NHs). Although […]

The feasibility of an outpatient casemix classification system based on the health insurance database in Thailand

Health Systems Research Institute and Alliances :Published in Thai. The objective of this study was to examine the feasibility of an outpatient casemix classification system […]

Comparing the costs and use of services for military care in military and civilian facilities

Orlando, FL, USA: AcademyHealth Annual Research Meeting. NORC at the University of Chicago, Bethesda, MD, USA RESEARCH OBJECTIVE: The objective is to compare the cost […]

The association between metformin therapy and mortality following breast cancer: a population-based study

Toronto, ON, Canada: University of Toronto (masters thesis). University of Toronto, Toronto, ON, Canada Metformin has been associated with a reduction in breast cancer incidence, […]

Resource Allocation Case Study-Government

The Ministry of Health in Chile used the ACG® System as a risk-adjustment mechanism to improve health care resource allocation and better describe the disease […]

Enhanced Use of Data for Case Management in England

Johns Hopkins Bloomberg School of Public Health The Enhanced Use of Primary Care, Ambulatory Hospital Data to Identify Patients for Case Management Programs in England […]

Customizing the Predictive Model

DST Health Solutions Customizing the Predictive Model Amy Salls

Using the ACG System for population segmentation and casemix adjustment

NHS Central Southern Commissioning Support Unit Using the ACG System for Population Segmentation and Casemix Adjustment Chris Morris Principal Analyst

Monday(C1)-A Model for the Risk of Unplanned Inpatient Readmission-Lemke

A Model for the Risk of Unplanned Inpatient Readmission-Klaus Lemke

Sunday-Workshop: Wrapping Your Hands Around the ACG System Advanced Reporting Options – Steve Sutch

Workshop: Wrapping Your Hands Around the ACG System Advanced Reporting Options – Steve Sutch – ACG International – Product Management Director

Using Case Mix To Improve Equity and the Delivery of Primary Care

Goals of Presentation To introduce concepts surrounding population-based case-mix and “predictive risk” modeling. To show examples of applications worldwide where case-mix has proved information to […]

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The ACG System Development Milestones

Jonathan Weiner, DrPH, Professor, Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, and ACG System co-developer provides an insight into the evolution […]

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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 […]

Outcomes of patients with chronic obstructive pulmonary disease diagnosed with or without pulmonary function testing

Background: A small number of people with chronic obstructive pulmonary disease (COPD) receive pulmonary function testing around the time of diagnosis. Because omitting testing increases […]

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 […]

A Canadian Population-Based Cohort to the Study Cost and Burden of Surgically Resected Hidradenitis Suppurativa

Abstract Background: Hidradenitis suppurativa (HS) is a chronic debilitating disease with long-lasting comorbidities that impose direct and indirect costs on the health care system. However, […]

Medicaid trends in prescription opioid and non-opioid use by HIV status

Abstract   Background Pain is more common among people living with HIV (PLWH) than their counterparts; however, it is unclear whether analgesic use differs by […]

Supporting general practice to make timely decisions for better health care: a population health approach

Abstract Primary Health Networks (PHNs) are tasked to enhance the efficiency and effectiveness of general practice. Gold Coast Primary Health Network (GCPHN) has been collecting […]

Is Post-discharge Rehabilitation Timing Associated with 90-Day Readmission in Primary Total Joint Arthroplasty?

Abstract Background Physical therapy (PT) is an accepted standard of care after total joint arthroplasty (TJA) and essential to maximizing joint functionality and minimizing complications […]

Prediction of 30-day pediatric unplanned hospitalizations using the Johns Hopkins Adjusted Clinical Groups risk adjustment system

Abstract Background The Johns Hopkins ACG System is widely used to predict patient healthcare service use and costs. Most applications have focused on adult populations. […]

Impact of comprehensive care on health care use among a cohort of marginalized people living with hepatitis C in Toronto, Canada

Abstract Background The majority of new hepatitis C (HCV) cases occur among people who inject drugs. In recent years, multidisciplinary models of HCV treatment have […]

Association of Follow-Up Care With Long-Term Death and Subsequent Hospitalization in Patients With Atrial Fibrillation Who Receive Emergency Care in the Province of Ontario

Abstract Background Currently, 11% of patients seen in the emergency department for atrial fibrillation die within 1 year of the visit. Our objective was to […]

Measuring multimorbidity beyond counting diseases: systematic review of community and population studies and guide to index choice

Abstract Objectives To identify and summarise existing indices for measuring multimorbidity beyond disease counts, to establish which indices include mental health comorbidities or outcomes, and […]

Health characteristics of reproductive-aged autistic women in Ontario: A population-based, cross-sectional study

Abstract While an increasing number of girls and women are being identified with autism, we know little about the health of reproductive-aged autistic women. Our […]

The effect of frailty on postoperative readmissions, morbidity, and mortality in endometrial Cancer surgery

Abstract Objectives To determine the impact of frailty on postoperative readmission, morbidity, and mortality among patients undergoing surgery for endometrial cancer. Methods Patients with endometrial […]

Association between mental health comorbidity and health outcomes in type 2 diabetes mellitus patients

Abstract Background Type 2 diabetes mellitus (T2D) is often accompanied by chronic diseases, including mental health problems. We aimed at studying mental health comorbidity prevalence […]

Analysis of modifiable and nonmodifiable risk factors in patients undergoing pituitary surgery

Abstract OBJECTIVE Pituitary adenomas (PAs) are among the most common intracranial tumors. Understanding the clinical effects of various modifiable risk factors (MRFs) and nonmodifiable risk […]

Health care service use and costs for a cohort of high-needs elderly diabetic patients

Abstract Aims To describe the impact of diabetes comorbidities on the health care services use and costs of a cohort of elderly patients with diabetes […]

Management and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system

Abstract Hypothesis There is limited data on the care and outcomes of individuals with both chronic obstructive pulmonary disease (COPD) and lung cancer, particularly in […]

Guideline interval: A new time interval in the diagnostic pathway for symptomatic cancer

Abstract Background: A standard measure of the cancer diagnostic pathway, diagnostic interval, is the time from “first presentation of cancer” to diagnosis. Cancer presentation may be […]

Impact of Frailty on Clinical and Financial Outcomes Following Minor Lower Extremity Amputation: A Nationwide Analysis

Abstract Objective Frailty has been shown to portend worse outcomes in surgical patients. Our goal was to identify the impact of frailty on outcomes and […]

The clinical impact of frailty on the postoperative outcomes of patients undergoing gastrectomy for gastric cancer: a propensity-score matched database study

Abstract Background Frailty aggregates a composite of geriatric and elderly features that is classified into a singular syndrome; literature thus far has proven its influence […]

Outcomes of SARS-CoV-2 infection in cancer versus non-cancer-patients: A population-based study in northeastern Italy

Abstract Introduction This study assesses the risk of infection and clinical outcomes in a large consecutive population of cancer and non-cancer patients tested for SARS-CoV-2 […]

Survival effects of time to surgery for Stage I lung cancer: A population-based study

Abstract Objectives To examine the impact of time to surgery (TTS) on survival among patients with stage I non-small cell lung cancer (NSCLC). Methods All […]

Development and validation of predictive models for unplanned hospitalization in the Basque Country: analyzing the variability of non-deterministic algorithms

Abstract Background The progressive ageing in developed countries entails an increase in multimorbidity. Population-wide predictive models for adverse health outcomes are crucial to address these […]

Health Utilities in People with Hepatitis C Virus Infection: A Study Using Real-World Population-Level Data

Abstract Background Hepatitis C virus (HCV) infection is associated with reduced quality of life and health utility. It is unclear whether this is primarily due […]

Delay in Diabetes Diagnosis After High-Deductible Health Plan Enrollment: A Pre-Post Study with Control

Abstract Background High-deductible health plan (HDHP) members face relatively high out-of-pocket (OOP) costs for urgent care, high-acuity care, and secondary prevention. These costs could affect […]

Using Machine Learning To Predict Future Foster Care Admission

Structured Abstract Introduction Foster care admissions are highly traumatic for children and their families, often causing serious adverse outcomes. We seek to assess the viability […]

Impact of age and frailty on acute care use during immune checkpoint inhibitor treatment

Abstract Purpose Older and frail adults were under-represented in clinical trials evaluating ICIs, leading to a knowledge gap on their risk of acute care use […]

Disparities in End-of-Life Care: A Retrospective Study on Intensive Care Utilization and Advance Care Planning in the Colorado All-Payer Claims Database

Abstract Background Intensive end-of-life (EOL) care is emotionally and financially burdensome, disproportionally negatively impacting racial and ethnic minorities, rural residents, and lower socioeconomic seniors. Objectives […]

Design and early evaluation of a social care network’s impact on health care costs

Abstract Introduction The Social Care Network (SCN) is a payor–provider-system integrated social care referral model designed to address historical challenges of scalability and sustainability through […]

Lung Transplantation in Rheumatoid Arthritis Related Interstitial Lung Disease: Risk Factors and Mortality in a Universal Health Care System

ABSTRACT Background Despite therapy, some patients with rheumatoid arthritis related interstitial lung disease (RA-ILD) require lung transplantation for progressive disease. We aimed to identify factors […]

Primary care continuity and breast cancer survival: a retrospective cohort study

Abstract Purpose Primary care provider (PCP) continuity improves many health outcomes, but its impact on breast cancer survival remains unclear. We examined how baseline PCP […]

Effect of periodic health exam on provider management of preventive services

Abstract Rationale and objective To evaluate the relationship between receipt of annual physicals and the receipt of provider recommendation for preventive services, during a period […]

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Using Additional Data Sets

This webinar explores the use of data sets from other Health and Social Care providers with the ACG system.In particular, it will focus on Sollis’s […]

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Inter-Relationship Between Frailty & Multimorbidity

Presented by: Alan Thompson, MSc
Director of User Support, ACG System

Whilst it is true that resource use increases with an increasing degree of frailty, this presentation will demonstrate that not all frail patients are high cost and not all high cost patients are frail.

The excess medical cost and health problems of family members of persons diagnosed with alcohol or drug problems

Med Care 45:116-122. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA BACKGROUND: Having a family member with substance use problems affects family functioning, […]

Is socioeconomic status associated with utilization of health care services in a single-payer universal health care system?

Int J Equity Health 13:115. Ben-Gurion University, Beer Sheva, Israel; Clalit Health Services, Tel Aviv, Israel OBJECTIVES: To assess an association of Socio-economic status with […]

Validation of 2 new measures of continuity of care based on year-to-year follow-up with known providers of health care

Ann Fam Med 12:559-567. Montreal Health and Social Services Agency, Montreal, QC, Canada PURPOSE: In a primary care context favoring group practices, we assessed the […]

The healthy migrant effect in primary care

Gac Sanit 29:15-20. Aragón Health Sciences Institute (IACS), Zaragoza, Spain; University of Zaragoza, Zaragoza, Spain; Miguel Servet University Hospital, Zaragoza, Spain; Carlos III Health Institute, […]

Medication oversupply in patients with diabetes

Res Social Adm Pharm 11:382-400. Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA; University of Pittsburgh, PA, USA; University of Wisconsin, Madison, WI, USA; Pharmacy […]

Prognostic factors in metastatic gastric cancer: results of a population-based, retrospective cohort study in Ontario

Gastric Cancer 19:150-159. Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA BACKGROUND: Stage IV gastric cancer is lethal, and little population-based research on prognostic […]

The temporal risk of heart failure associated with adjuvant trastuzumab in breast cancer patients: a population study

J Natl Cancer Inst 108:10. University of Toronto, Toronto, ON, Canada; St. Michael’s Hospital, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; […]

The origin of variation in primary care process and outcome indicators: patients, professionals, centers, and health districts

Medicine 94:e1314. Centro de Salud de Astrabudua (Primary Health Care Center of Astrabudua), Osakidetza (Basque Health Service), Erandio (Bizkaia), Spain; Primary Care Research Unit-Bizkaia, Osakidetza, […]

Characteristics of physicians and patients who join team-based primary care practices: evidence from Quebec’s Family Medicine Groups

Health Policy 116:264-272. McGill University, Montreal, QC, Canada; Direction de la santé publique de l’Agence de la Santé et des services sociaux de Montréal, Montreal, […]

Adjusted Clinical Groups Method (ACG) to allocate resources according to the disease burden of each health center

Santelices C E, Muñoz P F, Muñiz P, Rojas J. BACKGROUND: Health care must be provided with strong primary health care models, emphasizing prevention and a […]

Determining the morbidity profile, health-service utilization and health-provider efficiency in the Rejang River Basin, Sarawak, based on TPC® data and the Johns Hopkins ACG® System

BMC Health Serv Res 10:A8. Ministry of Health, Malaysia; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Introduction: The study focused on the […]

Validating the Johns Hopkins ACG Case-Mix System of the elderly in Swedish primary health care

BMC Public Health 6:171. Blekinge Institute for Research & Development, Karlshamn, Sweden BACKGROUND: Individual based measures for comorbidity are of increasing importance for planning and […]

Use of diagnosis-based risk adjustment models to predict individual health care expenditure under the National Health Insurance system in Taiwan

J Formos Med Assoc 104:883-890. Graduate Institute of Health Care Organization Administration, College of Public Health, National Taiwan University, Taipei, Taiwan. BACKGROUND AND PURPOSE: Diagnostic […]

Risk adjustment using administrative data-based and survey-derived methods for explaining physician utilization

Med Care 48:175-182. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada OBJECTIVES: The objective of this study was to evaluate an administrative data-based risk adjustment […]

An in-depth assessment of a diagnosis-based risk adjustment model based on national health insurance claims: the application of the Johns Hopkins Adjusted Clinical Group case-mix system in Taiwan

BMC Med 8:7. Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA BACKGROUND: Diagnosis-based risk adjustment is […]

Predicting healthcare costs in a population of Veterans Affairs beneficiaries using diagnosis-based risk adjustment and self-reported health status

Med Care 42:1027-1035. Houston Center for Quality of Care and Utilization Studies, Health Services Research and Development Service, Michael E. DeBakey Veterans Affairs Medical Center, […]

Evaluation of guideline-concordant care for bipolar disorder among privately insured youth

Prim Care Companion J Clin Psychiatry 12:PCC.09m00837. Health Services Research Department, Institute of Psychiatry, King’s College London, London, UK OBJECTIVE: To describe and quantify the […]

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 […]

In search of the perfect comorbidity measure for use with administrative claims data: does it exist?

Med Care 44:745-753. Department of Family Medicine, University of Washington, Seattle, WA, USA BACKGROUND: Numerous measures of comorbidity have been developed for health services research […]

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 […]

Comparison of private for-profit with private community-governed not-for-profit primary care services in New Zealand

J Health Serv Res Policy 9 Suppl 2:17-22. Department of Public Health, Wellington School of Medicine and Health Sciences, Wellington, New Zealand OBJECTIVE: To compare […]

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 validity of claims-based risk estimation in underinsured populations

Am J Manag Care 18:e468-e476. Institute for Health and Disability Policy Studies, University of Kansas, Lawrence, KS OBJECTIVES: To demonstrate a threat to validity in […]

The post-fracture care gap among Canadian First Nations peoples: a retrospective cohort study

Osteoporos Int 23:929-936. Department of Medicine, University of Manitoba, 409 Tache Avenue, Winnipeg, MB, Canada Despite targeted attempts to reduce post-fracture care gaps, we hypothesized […]

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 […]

Cardiology workforce: a shortage, not a surplus

Health Aff W4:64-66. Mayo Clinic College of Medicine, Rochester, MN, USA The United States faces a serious shortage of cardiologists as our population ages and […]

Adjusted Clinical Groups use as a measure of the referrals efficiency from primary care to specialized in Spain

Eur J Public Health 17:657-663. Planning Management, Badalona Serveis Assistencials, SA, Badalona, Barcelona, Spain BACKGROUND: To determine the referral rate (RR) per centre, its main […]

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 […]

Chronic care improvement in primary care: evaluation of an integrated pay-for-performance and practice-based care coordination program among elderly patients with diabetes

Health Serv Res 45:1763-1782. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Johns Hopkins Healthcare LLC, Glen Burnie, MD, USA OBJECTIVE: […]

Implementation of electronic medical records: effect on the provision of preventive services in a pay-for-performance environment

Can Fam Physician 57:e381-e389. Department of Family and Community Medicine, University of Toronto, ON, Canada OBJECTIVE: To study the effect of electronic medical record (EMR) […]

Estimation of chronic co-morbidity on health costs in elderly patients with neurological disorders

Rev Peru Med Exp Salud Publica 28:564-565. Published in Spanish. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain Sr. Editor. El envejecimiento progresivo de […]

Medical care costs associated with traumatic brain injury over the full spectrum of disease: a controlled population-based study

J Neurotrauma 29:2038-2049. Mayo Clinic, Rochester, MN, USA Data on traumatic brain injury (TBI) economic outcomes are limited. We used Rochester Epidemiology Project (REP) resources […]

The performance of administrative and self-reported measures for risk adjustment of Veterans Affairs expenditures

Health Serv Res 40:887-904. Health Services Research and Development Northwest Center of Excellence, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. OBJECTIVE: To […]

Socio-economic position and childhood multimorbidity: a study using linkage between the Avon Longitudinal study of parents and children and the general practice research database

Int J Equity Health 12:66. School of Social and Community Medicine, University of Bristol, Bristol, UK INTRODUCTION: In adults, multimorbidity is associated with social position. […]

Use of risk adjustment in setting budgets and measuring performance in primary care II: advantages, disadvantages, and practicalities

BMJ 323:607-610. School of Public Policy, University College London, London, UK Risk adjustment could help to improve decisions about budgets as well as help measure […]

Prevalence of multimorbidity according to the deprivation level among the elderly in the Basque Country

BMC Public Health 13:918. Oberri, Basque Institute for Healthcare Innovation, Sondika, Spain BACKGROUND: Multimorbidity is clearly a major challenge for healthcare systems. However, currently, its […]

Predictors of colorectal cancer screening variation among primary-care providers and clinics

Am J Gastroenterol 108:1159-1167. University of Wisconsin School of Medicine and Public Health, Madison, WI, USA OBJECTIVES: Colorectal cancer (CRC) screening is underutilized. To effect […]

Antihypertensive medication initiation among young adults with regular primary care use

J Gen Intern Med Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA BACKGROUND: Young adults with hypertension have […]

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 […]

Obesity and co-morbidities in type 2 diabetes: an opportunity to bend the Health Care Cost Curve

Rev Clin Esp 214:140-142. University of Southern Denmark, Odense, Denmark Obesity has long been known as a driver and predictor of the increasing global prevalence […]