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Ambulatory specialist use by nonhospitalized patients in us health plans: correlates and consequences

J Ambul Care Manage 32:216-225. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Approximately 7 of 10 (and 95% of the elderly) people […]

Impact of comorbidity on the individual’s choice of primary health care provider

Scand J Prim Health Care 29:104-109. Lund University, Department of Clinical Sciences in Malmö, General Practice/Family Medicine, Malmö, Sweden OBJECTIVE. This study examined whether age, […]

Comparing asthma care provided to Medicaid-enrolled children in a primary care case manager plan and a staff model HMO

Ambul Pediatr 3:253-262. Health Policy Institute, Georgetown University, Washington, DC, USA OBJECTIVE: To examine differences in selected processes of asthma care provided to Medicaid-enrolled children […]

Economic profiling of primary care physicians: consistency among risk-adjusted measures

Health Serv Res 39:985-1003. Health Management and Policy, University of Michigan, Ann Arbor, MI, USA OBJECTIVE: To investigate whether different risk-adjustment methodologies and economic profiling […]

Access intervention in an integrated, prepaid group practice: effects on primary care physician productivity

Health Serv Res 43:1888-1905. Department of Health Services, University of Washington, Seattle, WA, USA OBJECTIVE: To estimate the joint effect of a multifaceted access intervention […]

Risk classification of adult primary care patients by self-reported quality of life

Med Care 43:189-193. Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA BACKGROUND: Although patient-reported health-related quality of life (HRQOL) is […]

Sleep complaints and their association with comorbidity and health-related quality of life in an older population in Sweden

Aging Ment Health 15:204-213. School of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden OBJECTIVE: The relationship between sleep complaints, comorbidity and health-related quality of […]

Patients with atrial fibrillation and an alternative primary diagnosis in the emergency department: a description of their characteristics and outcomes

Acad Emerg Med 20:193-199. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada OBJECTIVES: Atrial fibrillation is common in the emergency department (ED). Mortality rates at […]

Physical activity and influenza-coded outpatient visits, a population-based cohort study

PLoS One 7:e39518. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada BACKGROUND: Although the benefits of physical activity in preventing chronic medical conditions are well […]

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

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

Pharmaceutical use among older adults: using administrative data to examine medication-related issues

Can J Aging 24 Suppl 1:81-95. Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada Medication use is […]

The effects of complications and comorbidities on the quality of preventive diabetes care: a literature review

Popul Health Manag 11:217-218. Mathematica Policy Research, Washington, DC, USA Although concurrent conditions such as complications and comorbidities are common in people with diabetes, both […]

Cost of arterial hypertension according to levels of morbidity in primary care setting

Med Clin (Barc) 133:290-295. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials SA, Badalona, Barcelona, España BACKGROUND AND OBJECTIVE: To determine the health care […]

Case study: the Minneapolis Buyers Health Care Action Group

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

Physician and patient factors associated with follow up of high grade dysplasias of the cervix: a population-based study

Gynecol Oncol 120:63-67. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Toronto, Toronto, ON, Canada OBJECTIVE: This population-based study characterizes available physician […]

Comparative ability of comorbidity classification methods for administrative data to predict outcomes in patients with chronic obstructive pulmonary disease

Ann Epidemiol 22:881-887. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada PURPOSE: Administrative healthcare databases are used for health services research, comparative effectiveness studies, and […]

Review of methods used to measure comorbidity in cancer populations: no gold standard exists

J Clin Epidemiol 65:924-933. Cancer Control and Screening Research Group, Department of Public Health, University of Otago, Wellington South, New Zealand OBJECTIVE: This article reviews […]

Evaluating early repeat emergency department use in patients with atrial fibrillation: a population-based analysis

Am Heart J 165:939-948. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada BACKGROUND: Emergency department (ED) use by patients with atrial fibrillation is high and […]

Primary care utilization and mental health diagnoses among adult patients requiring interpreters: a retrospective cohort study

J Gen Intern Med 28:386-391. Office of Women’s Health, Mayo Clinic, Rochester, MN, USA BACKGROUND: Patients requiring interpreters may utilize the health care system differently […]

Association between metformin therapy and mortality after breast cancer: a population-based study

Diabetes Care 36:3018-3026. Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada OBJECTIVE: Metformin has been associated with a reduction in breast cancer risk […]

Primary care doctors’ opinion on a risk adjustment system: Adjusted Clinical Groups

Rev Peru Med Exp Salud Publica 30:345-347. Published in Spanish. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain No abstract

Impact of rheumatoid arthritis on receiving a diagnosis of hypertension among patients with regular primary care

Arthritis Care Res Department of Medicine, Rheumatology Division, University of Wisconsin, Madison, WI, USA OBJECTIVE: Despite numerous studies reporting increased cardiovascular disease (CVD) in patients […]

Comorbidity of dementia: a cross-sectional study of primary care older patients

BMC Psychiatry 14:84. EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), University Hospital, Zaragoza, Spain BACKGROUND: The epidemiologic study of comorbidities of […]

The impact of morbidity trajectories on identifying high-cost cases: using Taiwan’s National Health Insurance as an example

J Public Health 36:300-307. Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. BACKGROUND: Incorporating longitudinal information […]

Exploring the Johns Hopkins Aggregated Diagnosis Groups in administrative data as a measure of child health

This study explored the utility of the Johns Hopkins Aggregated Diagnostic Groups (ADGs) as a noncategorical measure of child health in administrative health data. Canadian […]

The hassle of wellness: do peers and health status matter?

In: Population Association of America, eds. 2014 Annual Meeting, Population Association of America. Princeton, NJ, USA: Population Association of America. Cornell University, Ithaca, NY, USA […]

A data-driven approach towards patient identification for telehealth programs

2015 IEEE International Conference on Big Data :2551-2559. Robert Bosch (US), Palo Alto, CA, USA Telehealth provides an opportunity to reduce healthcare costs through remote […]

An actuarial perspective on healthcare expenditure in the last year of life

Washington, DC: International Congress of Actuaries. University of Cape Town, South Africa The aim of this paper is to highlight the key methodological considerations in […]

A hierarchical multivariate two-part model for profiling providers’ effects on health care changes

J Am Statistical Assoc 101:911-923. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Procedures for analyzing and comparing health care providers’ effects on […]

Risk adjustment in state Medicaid programs

Health Watch :14-17, 32-34. Denver, Colorado, office of Wakely Consulting Group This article discusses some of the most important considerations in implementing risk adjustment within […]

Health-based risk adjustment: application to premium development and profiling

In: Wrightson CW, eds. Financial strategy for managed care organizations: rate setting, risk adjustment, and competitive advantage. Ann Arbor, MI, USA: Health Administration Press:165-225. Health […]

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

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

How well do models work? Predicting health care costs

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

A risk stratification model for adult patients with obstructive sleep apnea: development and evaluation

Toronto, ON, Canada: Institute for Clinical Evaluative Sciences. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada STUDY HYPOTHESES: We hypothesize that the apnea-hypopneas index (AHI), […]

Studying effects of primary care physicians and patients on the trade-off between charges for primary care and specialty care using a hierarchical multivariate two-part model

Department of Biostatistics Working Paper 51. Baltimore, MD, USA: Johns Hopkins University. Johns Hopkins University, Baltimore, MD, USA OBJECTIVE. To examine effects of primary care […]

An incentive mechanism for using risk adjuster to reimburse health care provider

York, UK: University of York. University of York, York, UK Health care providers are almost always universally reimbursed by third party purchasers. As a result, […]

Prompt reduction in use of medications for comorbid conditions after bariatric surgery

Rockville, MD, USA: Agency for Healthcare Research and Quality. Johns Hopkins University, Baltimore, MD, USA BACKGROUND. Bariatric surgery leads to weight loss, but it is […]

The dynamic effects of medical risk costs: evidence from quantile regression

Journal of Statistics and Management Systems 14:843-868. This paper adopted the quantile regression (QR) estimator to assess the effects of the medical utilization factors (changes […]

An economic analysis of secure messaging between patients and providers

Seattle, WA, USA: University of Washington (doctoral dissertation). University of Washington, Seattle, WA, USA This dissertation presents an economic analysis of patient-provider communication through secure […]

Comorbilidad y discapacidad en pacientes con insuficiencia cardiaca

Madrid, Spain: Universidad Autonoma de Madrid (doctoral dissertation). Published in Spanish. Universidad Autonoma de Madrid, Madrid, Spain INTRODUCCIÓN: La insuficiencia cardiaca (IC) es un problema […]

Thiazolidinedione use and risk of hospitalization for pneumonia in type 2 diabetes:  population based matched case-control study

F1000Research 2:145. Department of Medicine, Johns Hopkins University Schools of Medicine and Public Health, Baltimore, MD, USA OBJECTIVE: Previous randomized clinical trials and their meta-analyses […]

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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.

Facilitating Equity and Efficiency in Primary Health Care

Johns Hopkins University Facilitating Equity & Efficiency in Primary Health Care, Malaysia using the ACG Case Mix System Dr Karen Kinder Executive Director

Tuesday-Re-thinking ACG fundamentals-Kitching and Heim

HealthPartners Risk Adjustment in Total Cost of Care & Resource Use: Re-Thinking Risk Adjustment Chad Heim Gary Kitching

Monday-US Health Reform-Ewald

Minnesota Department of Human Services The MN Health Care Home Initiative and ACG Dean Ewald

Monday-Care Coordination II-Haas

Mayo Clinic Assessment of Risk Stratification Methods Identifying Patients for Care Coordination within a Medical Home Lindsey R. Haas, MPH

Pilot study using Risk Stratification in Thames

Richmond Clinical Commissioning Group Using ACG to Support Delivery of Integrated Care Anna Raleigh, Consultant in Public Health Dr Caoimhe O Sullivan, Public Health Principal […]

Health Insurance Marketplace

DST Health Solutions Health Insurance Marketplace Amy Salls

Monday(C4)-Identifying Near Term Heath Cost Risk in the Absence of Claims Data—Bernard Khomenko

Identifying Near Term Heath Cost Risk  in the Absence of Claims Data   —Bernard Khomenko, CEBS Vice President of Client Solutions, Data Smart Solutions 

Tuesday(C8)-Using the ACG Software for a Full Picture of Population Risk Under the Accountable Care Act (ACA)-Salls and Bodycombe

Using the ACG Software for a Full Picture of Population Risk Under the Accountable Care Act (ACA) —Amy Salls, DST Health Solutions  David Bodycombe, Johns […]

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The Future of the ACG System

Hadi Kharrazi, MD, PhD, Assistant Professor Health Policy and Management, Johns Hopkins Bloomberg School of Public Health talks about EMRs, other future data sources and […]

Conference Welcome – Amy Salls

ACG Training Conference WelcomeAmy Salls Director, Population Health Strategy DST Health Solutions 

01 Welcome & Introduction – Alan Thompson

Alan Thompson Director of User Support Johns Hopkins HealthCare Solutions

02 Population Health Management – Ming Tang

Ming Tang Director of Data & Analytics Data, Analysis and Insights Service (DAIS) NHS England and NHS Improvement

Welcome & Introduction – Jonathan Weiner & Mark Cochran

Welcome and IntroductionJonathan Weiner Professor and Director, Center for Population Health IT  Mark Cochran Executive Director, Johns Hopkins HealthCare Solutions

03 Complex Case Management Programme – Jim O’Donnell

Dr. Jim O’Donnell Slough Locality Lead, NHS East Berkshire CCG Frimley ICS Clinical Commissioning Lead EBCCG Reducing Variation Workstream Clinical Lead Deputy Chair Slough Wellbeing […]

04 Advances in Population Health Sharing Insights – GE Healthcare & Sollis

Pat Nichols, GE Sarah Ouanhnon, GE Graham Head, Sollis

05 From Cake-mix to Case-mix – David Shepherd

Dr. David Shepherd GP & HNN Lead Leicester City CCG

06 Working Together to Deliver Population Health – Chris Roche

Chris Roche Information Manager Gloucestershire STPPlease note: There are three buttons below. One will link to the presentation slides. One will link to a separate […]

07 Using Predictive Models to Support Case Finding – David Brown & Peter Glover

Dr. David Brown Peter Glover Farnham Integrated Care Services

08 Risk-Adjusted Resource Allocation in Leicester – Mark Pierce

Mark Pierce Senior Strategy & Implementation Manager Leicester City CCG

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COVID-19: Marathon Health Outreach

By leveraging the Johns Hopkins ACG System, Marathon Health was able to offer outreach and options to individuals identified as a higher risk of contracting or experiencing complications as a result of COVID-19.

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Recalibration of Predictive Models

This short report provides details of the third recalibration of the predictive models within the ACG System for the UK.

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Reducing Disparities in the Delivery of Primary Care

This report details the work of 2020 Starfield award winner Discovery Health to demonstrate, using the Johns Hopkins ACG System, the impact of improving primary care utilization.

01 David Shephard – Casemix Adjustment in Primary Care

Dr. David Shephard GP and Health Need Neighbourhood Chair, Leicester South

01 Karen Kinder Welcome Presentation

ACG System Dr. Karen Kinder Executive Director

Session 1: Brad Myers – Version 12 Supplementary Data

Version 12 Supplementary Medical ServicesBrad Myers DST Health Solutions 

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New Medicaid Enrollees with Highest Care Needs

The ACG System can help identify new Medicaid enrollees with high care needs.

02 David Colin Thome – Primary Care Home

The Primary Care Home (PCH) David Colin-Thomé Independent Healthcare consultant Visiting Professor Manchester Business School Former General Medical Practitioner and National Clinical Director for Primary […]

Keynote I – Jonathan Weiner – Analytics & Big Data in Support of the Social and Medical Health of Populations

Analytics & Big Data in Support of the Social and Medical Health of Populations: The ACG System Today and TomorrowJonathan P. Weiner, DrPH Professor and […]

Session 2: Don McGaw – Version 12 JHU ED Visit Classification

Version 12 JHU ED Visit ClassificationDon McGaw DST Health Solutions 

Session 1: Mitchell – Assessing Patient Morbidity: Risk Factors

DST Health Solutions Assessing Patient Morbidity: Risk Factors Anna-Marie Mitchell Senior Product Consultant

03 Nick Harding – Challenges Faced By Primary Care

NHS Sandwell and West Birmingham Clinical Commissioning Group The challenges faced by primary care and the need for good quality information Professor Nick Harding OBE FRCGP […]

Session 3: Anna-Marie Mitchell – Version 12 Laboratory Measures

Version 12 Laboratory MeasuresAnna-Marie Mitchell Senior Analytic Product Consultant DST Health Solutions 

Session 2: Myers – Hospitalization Risk

DST Health Solutions Hospitalization Models Brad Myers Predictive Modeling Product Consultant

Session 4: Amy Salls – Assessing Candidates for Care Coordination

Assessing Candidates for Care CoordinationAmy Salls Director, Population Health Strategy DST Health Solutions 

Session 3: McGaw – Care Coordination

DST Health Solutions Care Coordination and Care Density Donald D. McGaw Jr. Client Relations Consultant

05 Lizelle Steenkamp – Segmentation and the Impact of Vitality

Discovery Health Vitality Segmentation and impact of Vitality (Population Health Management) Lizelle Steenkamp

Session 4: Salls – Assessing Candidates for Care Management

DST Health Solutions Assessing Candidates for Care Management Programs Amy Salls Director, Population Health Strategy

Hospitalization Risk Scores: Amy Salls, DST Health Solutions

ACG System DST Health Solutions Hospitalization Models Amy Salls

Session 5: Sokchay Chiv & Kate Hollidge – Catching a Breath Program for COPD

Catching a Breath Program: Implementing and Expanding Clinical ProgramsSokchay Chiv Director, Population Health Strategies Meridian Health PlanKate Hollidge Senior Manager, Population Health Programs Meridian Health […]

Data Validation: Lisa Kabasakalian, DST Health Solutions

ACG System DST Health Solutions The Johns Hopkins ACG® System Data Validation Lisa Kabasakalian

Session 5: DiLorenzo – An Analysis of Risk Scores of Patients with Less Than Twelve Months of Claims History

MVP Health Care Analysis of Risk Scores of Patients with Incomplete Claims History Tyson DiLorenzo, PhD. Manager, Finance & Actuarial Analytics at MVP

Session 6: Brad Myers – Version 12 Opioid Markers

High Risk Opioid Use MarkersBrad Myers DST Health Solutions 

06 James Barrett – The Benefits of an Integrated Dataset When Predicting Future Risk

James Barrett Johns Hopkins HealthCare Solutions Johns Hopkins ACG System

Assessing the Impact of Incomplete Date: Kelsey Rauch, DST Health Solutions

ACG System DST Health Solutions Patient Identification with Incomplete Data Kelsey Rauch

07a Mark Pierce – Applying the ACG System in Whole Population Management

Leicester, Leicestershire and Rutland Integrated Teams Mark Pierce

Session 5: Khomenko – Health Questionnaires and Population Risk Indexing

DataSmart Solutions Health Questionnaires and Population Risk Indexing Bernard Khomenko, CEBS Vice President of Client Services

Session 7: Sokchay Chiv & Kate Hollidge – Opioids Among the Masses

Opioids Among the Masses: Using Advanced Analytics to Drive Clinical ProgramsSokchay Chiv Director, Population Health Strategies Meridian Health PlanKate Hollidge Senior Manager, Population Health Programs […]

07 Alan Thompson – Segmentation: Exploring the Relationship Between Frailty and Other High-Risk Groups

Alan Thompson Johns Hopkins HealthCare Solutions Johns Hopkins ACG System