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Documents

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 […]

Improving Models to Predict Care Utilization Using Machine Learning: Retrospective Observational Study

Abstract Background The use of artificial intelligence and machine learning (ML) tools is now common in the advancement of health care services and clinical risk […]

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Risk Stratification with only EHR Data – White Paper

Risk stratification models have traditionally used medical and pharmacy claims data combined with other sources, such as electronic health records (EHRs).  But provider organizations often […]

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Reducing Emergency Department Use

People usually go to the Emergency Department (ED) when they are experiencing a medical emergency. But some people choose the ED for non-urgent care, which […]

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Case Mix Measurement

This webinar provides an introduction to the principle of case mix and the constructs within the ACG System that make this possible. This session is a […]

Applications of the ACG System in the UK

This white paper provides an overview of the ACG System and how it is being used to support a range of clinical and commissioning activities […]

Physician referral rates: style without much substance?

Med Care 38:836-846. Department of Family Medicine, University of Rochester, New York, NY, USA BACKGROUND: Primary care physicians (PCPs) exhibit widely varying referral rates, resulting […]

Constructing ”behavioral” comparison groups: a difference-in-difference analysis of the effect of copayment based on the patient’s price elasticity

Eval Health Prof 37:434-456. National Kaohsiung First University of Science and Technology, Kaohsiung, Taiwan It is well known that the differences-in-differences (DD) estimator is based […]

Revisiting the economic efficiencies of observation units

Manag Care 24:46-52. University of Texas, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center HSR&D, Houston, TX, USA; Baylor College of Medicine, Houston, […]

Palliative care and the aggressiveness of end-of-life care in patients with advanced pancreatic cancer

J Natl Cancer Inst 107:p11: kju424. University Health Network, Toronto, ON, Canada; Institute of Medical Sciences, Toronto, ON, Canada BACKGROUND: We examined the impact of […]

Predicting costs of care using a pharmacy-based measure risk adjustment in a veteran population

Med Care 41:753-760. VA Puget Sound Health Care System, Seattle, WA, USA BACKGROUND: Although most widely used risk adjustment systems use diagnosis data to classify […]

Process of care for Medicaid-enrolled children with asthma: served by community health centers and other providers

Med Care 40:303-314. Institute for Health Care Research and Policy, Georgetown Public Policy Institute, Georgetown University, Washington, DC, USA OBJECTIVE: To compare the process of […]

A population-based study evaluating family physicians’ HIV experience and care of people living with HIV in Ontario

Ann Fam Med 13:436-445. Bruyère Research Institute, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Institute for […]

Sex disparities in post-acute myocardial infarction pharmacologic treatment initiation and adherence: problem for young women

Circ Cardiovasc Qual Outcomes 8:586-592. University of British Columbia, Vancouver, BC, Canada BACKGROUND: The prevalence of the use of secondary prevention cardiovascular medications is lower […]

Increased surgeon experience with rheumatoid arthritis reduces the risk of complications following total joint arthroplasty

Arthritis Rheumatol 66:488-496. University of Toronto and Women’s College Hospital, Toronto, ON, Canada OBJECTIVE: To determine the relationship between surgeon experience with, and complications following, […]

Prevalence, expenditures, and complications of multiple chronic conditions in the elderly

Arch Intern Med 162:2269-2276. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA BACKGROUND: The prevalence, health care […]

Ambulatory care groups: a categorization of diagnoses for research and management

Health Serv Res 26:53-74. Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA This article describes a […]

Using the Johns Hopkins aggregated diagnosis groups (ADGs) to predict mortality in a general adult population cohort in Ontario, Canada

Med Care 49:932-939. Institute for Clinical Evaluative Sciences, Department of Health Management, Policy and Evaluation, University of Ottawa, Ottawa, ON, Canada BACKGROUND: Administrative healthcare databases […]

Preventable hospitalizations and socioeconomic status.

Health Aff 17:177-189. Wagner Graduate School, New York University, New York, NY, USA. “Preventable” hospitalizations have been proposed as indicators of poor health plan performance. […]

Applying diagnosis and pharmacy-based risk models to predict pharmacy use in Aragon, Spain: the impact of a local calibration

BMC Health Serv Res 10:22. Aragon Health Science Institute, Zaragoza, Spain BACKGROUND: In the financing of a national health system, where pharmaceutical spending is one […]

Ambulatory Care Groups and the profiling of primary care physician resource use: examining the application of case mix adjustments

J Ambul Care Manage 19:86-89. Center for Research in Ambulatory Health Care Administration, Englewood, CO, USA A variety of profiling models and tools is utilized […]

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 […]

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 […]