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Explaining prescription drug use and expenditures using the Adjusted Clinical Groups case-mix system in the population of British Columbia, Canada

Med Care 48:402-408. Centre for Health Services and Policy Research, University of British Columbia, School of Population and Public Health, Vancouver, BC, Canada BACKGROUND: Given […]

Methods of reducing the financial risk of physicians under capitation

Arch Fam Med 8:149-155. Johns Hopkins Center for Hospital Finance and Management, Baltimore, MD, USA. In today’s rapidly changing medical marketplace, managed care plans are […]

Use of well-child visits in high-deductible health plans

Am J Manag Care 16:833-840. Center for Child Health Care Studies, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, […]

Risk adjustment for people with chronic conditions in private sector health plans

Med Decis Making 23:397-405. The MEDSTAT Group, Inc., Washington, DC, USA BACKGROUND: Although the problem of adverse selection into more generous health insurance plans has […]

Ambulatory care practice variation within a Medicaid program

Health Serv Res 30:751-770. Johns Hopkins University, School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA STUDY QUESTIONS: What is the […]

Tamoxifen use and osteoporotic fracture risk: a population-based analysis

J Clin Oncol 26:5227-5232. CancerCare Manitoba, Winnipeg, MB, Canada PURPOSE: Although tamoxifen has been shown to increase bone mineral density in clinical trials, it is […]

Patient race/ethnicity and shared medical record use among diabetes patients

Med Care 50:434-440. Center for Vulnerable Populations, University of California, San Francisco, CA, USA BACKGROUND: Previous studies have documented racial/ethnic differences in patients’ use of […]

Distribution of primary care expenditure according to sex and age group: a retrospective analysis

Aten Primaria 44:145-152. Published in Spanish. Centre d’Atenció Integral Dos de Maig, Consorci Sanitari Integral, Barcelona, Spain; Dirección de Planificación y Desarrollo Organizativo, Badalona Serveis […]

Ambulatory encounter systems: implications for payment and quality

J Ambul Care Manage 16:33-49. Many key decision makers are looking to AESs solely for purposes of payment. This approach is unfortunate because many systems […]

Identification of pharmacy cost outliers in primary care

Aten Primaria 41:453-459. Published in Spanish. Instituto Aragonés de Ciencias de la Salud, Zaragoza, España OBJECTIVE: To identify pharmacy cost outlier patients in Primary Care, […]

Impact of deductibles on initiation and continuation of psychotherapy for treatment of depression

Health Serv Res 47:1561-1579. Group Health Research Institute and University of Washington, Seattle, WA, USA OBJECTIVE: To estimate the impact of deductibles on the initiation […]

Ambulatory care sensitive hospitalizations and emergency visits: experiences of Medicaid patients using federally qualified health centers

Med Care 39:551-561. MDS Associates, Wheaton, MD, USA BACKGROUND: Federally Qualified Health Centers (FQHCs) serve as regular sources of preventive and primary care for low-income […]

Health-risk-assessment tools used to predict costs in defined populations

J Healthc Inf Manag 14:31-57. Vanderbilt University Medical Center, Nashville, TN, USA With the Balanced Budget Act of 1997 mandating that the Health Care Financing […]

Comparison of risk adjusters for Medicaid-enrolled children with and without chronic health conditions

Ambul Pediatr 1:217-224. Department of Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD, USA OBJECTIVE: Several capitation payment […]

Retrospective application of Adjusted Clinical Groups (ACGs) at a primary care centre

Aten Primaria 37:439-445. Published in Spanish. Dirección de Planificación, Badalona Servicios Asistenciales S.A. Badalona, Barcelona, España OBJECTIVE: To evaluate retrospectively the application of adjusted clinical […]

Using health-related quality of life assessments to evaluate care support within Medicaid

Care Manag J 9:42-50. Center for Health Research, Kaiser Permanente, Portland, OR, USA CareOregon, an Oregon-based not-for-profit Medicaid health plan, successfully piloted a “CareSupport” model […]

Prescription drug coverage, health, and medication acquisition among seniors with one or more chronic conditions

Med Care 42:1056-1065. http://www.ncbi.nlm.nih.gov/pubmed/15586832. Department of Sociology, University of Washington, Seattle, WA, USA. BACKGROUND: The unabated rise in medication costs particularly affects older persons with […]

Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System.

BMC Public Health 11:432. Instituto Aragonés de Ciencias de la Salud, Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain BACKGROUND: There is evidence suggesting that the […]

A population-based study of periodontal care among those with and without diabetes

J Periodontol 82:1650-1656. Group Health Research Institute, Seattle, WA, USA BACKGROUND: Our objectives were to describe the prevalence of periodontal care (a marker of periodontitis) […]

The effect of complementary and alternative medicine claims on risk adjustment

Med Care 44:1078-1084. Department of Nursing, Boise State University, Boise, ID, USA OBJECTIVE: We sought to assess how the inclusion of claims from complementary and […]

Assessment of pharmacological strategies for management of major depressive disorder and their costs after an inadequate response to first-line antidepressant treatment in primary care

Ann Gen Psychiatry 11:22. AstraZeneca Medical Department, Madrid, Spain BACKGROUND: The aim of the study was to determine the most common treatment strategies and their […]

More data in health care will enable predictive modeling advances

Manag Care 22:39-41. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA No abstract PMID: 23451538

Is patient satisfaction in primary care dependent on structural and organizational characteristics among providers? Findings based on data from the national patient survey in Sweden

Health Econ Policy Law 8:317-333. Lund University School of Economics and Management, Lund, Sweden In parallel to market-like reforms in Swedish primary care, the gathering […]

Association between metformin use and risk of prostate cancer and its grade 

J Natl Cancer Inst 105:1123-1131. Division of Urology, Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, Toronto, ON, Canada BACKGROUND: Metformin is commonly […]

Inclusion of persons with mental illness in patient-centred medical homes: cross-sectional findings from Ontario, Canada

Open Med 7:e9-e20. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada BACKGROUND: In Ontario, Canada, the patient-centred medical home is a […]

Comparative operative outcomes of early and delayed cholecystectomy for acute cholecystitis: a population-based propensity score analysis

Ann Surg 259:10-15. Sunnybrook Research Institute, Sunnybrook Health Sciences Center; Li Ka Shing Knowledge Institute, St Michael’s Hospital; and ‡Institute for Clinical Evaluative Sciences, Toronto, […]

Effects of dementia on postoperative outcomes of older adults with hip fractures: a population-based study

J Am Med Dir Assoc. Queen’s University, Kingston, ON, Canada; Institute for Clinical Evaluative Sciences, Queen’s University, Kingston, ON, Canada; Women’s College Hospital, Toronto, ON, […]

Adverse cardiac events in older patients receiving venlafaxine: a population-based study

J Clin Psychiatry 75:e552-e558. Sunnybrook Health Sciences Centre, Toronto, ON, Canada OBJECTIVE: Venlafaxine is a commonly prescribed antidepressant, but whether its noradrenergic effects impart increased […]

Federal disaster declarations and denials: analyzing spatial equity in the implementation of the Stafford Act

Tampa, FL, USA: University of South Florida (doctoral dissertation). University of South Florida, Tampa, FL, USA Federal disaster declarations are authorized by the president under […]

VG primarvard i for hallande till riksrevisionens rapport “primaryvardens styrning – efter behov eller efterfragan?”

Vanersborg, Sweden: Vastra Gotalandsregionen. Published in Swedish. Vastra Gotalandsregionen, Vanersborg, Sweden

Evaluation of the Maryland Multi-Payor Patient Centered Medical Home Program

Final report. Columbia, MD: IMPAQ International. IMPAQ International, Columbia, MD, USA; Johns Hopkins University, Baltimore, MD, USA; University of Maryland, Baltimore, MD, USA The Maryland […]

Hold it – my patients are sicker! The importance of case mix adjustment to practitioner profiles in British Columbia

British Columbia Med J 43:328-333. Ministry of Health and Ministry Responsible for Seniors, Province of British Columbia; UBC Centre for Health Services & Policy Research, […]

Optimal pricing of employment-based health plans

Minneapolis, MN, USA: University of Minnesota (doctoral dissertation). University of Minnesota, Minneapolis, MN, USA Employer-provided health insurance is a major component of the health care […]

Selection of Medicaid beneficiaries for chronic care management programs: overview and uses of predictive modeling

Shrewsbury, MA: Center for Health Policy and Research. Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA, USA Effective use of […]

ACGs: an ambulatory care case-mix measure. Health Quality section update

Center for Health Quality Outcomes and Economic Research. Bedford, MA, USA: CHQOER Quarterly, ENRM VA Hospital. Center for Health Quality Outcomes and Economic Research, Bedford, […]

Morbidity, service utilization and health spending in Montrealers aged 65 and older in 2005-2006: an application of the Johns Hopkins “Adjusted Clinical Group” system

Montreal, QC, Canada: Montreal Health and Social Services Agency. Published in French; also have English translation. Montreal Health and Social Services Agency, Montreal, QC, Canada […]

Risk adjustment and Medicare

New York, NY, USA: Commonwealth Fund. Division of Health Policy Research and Education, Harvard University, Boston, MA, USA Almost all observers agree in principle that […]

Implementing a model for risk distribution among competing health plans

Final report. Princeton, NJ, USA: Robert Wood Johnson Foundation.

Health-based capitation risk adjustment in Minnesota public health care programs

Health Care Financ Rev 26:21-41. Gregory A. Gifford and Kevan R. Edwards are with the Minnesota Department of Health. David J. Knutson is with the […]

Facilitating equity and efficiency in Malaysian primary health care through the application of the ACG® case mix system

BMC Health Serv Res 9(Suppl 1):A7. Ministry of Health, Malaysia     Introduction: Malaysian health care is a parallel system with both public and private sectors. […]

Socioeconomic status and the use of medicines in the Ontario Public Drug Program

Canadian Public Policy 37:563-576. University of Toronto, Toronto, ON, Canada Residents of Ontario aged 65 years and older are covered by a provincially funded prescription […]

El analisis de la morbilidad y comorbilidad como instrumento para facilitar la gestion clinical y organizacion de los servicios en atencion primaria

SEMG 139:441-448. Published in Spanish. Gerencia de Atencion Primaria del Area de Salud de Tenerife, Spain No abstract

Coût de l’ordonnance des médecins généralistes: une analyse sur les données de l’EPPM

Economie Publique :239-269. Published in French. Ministère des Affaires sociales et de la Santé, Paris, France Cet article examine de manière critique la possibilité de  […]

The 2013 RHA indicators atlas

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada The results in this report show clearly that the […]

Paying for primary care: the factors associated with physician self-selection into payment models

Working paper no. 2014-06. Toronto, ON, Canada: Canadian Centre for Health Economics. Canadian Centre for Health Economics, Toronto, ON, Canada In this paper we use […]

Introduction and Applications of the ACG System on Veteran in Taiwan

Taipei Veterans General Hospital Introduction and Applications of the ACG System on Veteran Population in Taiwan Dr. Wui-Chiang Lee, MD, PhD. CEO, Taiwan Joint Commission on […]

Tuesday-Utilization-Freund

University Hospital Heidelberg Modelling care sensitivity using ACG® systems – Insights from a German cohort study Tobias Freund, MD.

Monday-Keynote II-Kinder

Johns Hopkins ACG System Looking Back, Looking Forward: Celebrating the ACG System’s 20 Year Role in Improving Health Care Karen Kinder Jonathan Weiner

Benefits for South Central

NHS – South Central Primary Care Trust Alliance Benefits from the ACG System in South Central Alan Thompson, Programme Manager

A comprehensive care management programme focused on emerging and high risk individuals

Medscheme High and Emerging Risk Population Management London Symposium on Case Mix Risk Stratification to Support Integrated Care

Tuesday(C7)-Use of ACG System for Health Plan Collaboration with Primary Care Practices to Reduce Inpatient Admissions —Melissa Sherry

Use of ACG System for Health Plan Collaboration with Primary Care Practices to Reduce Inpatient Admissions  —Melissa Sherry

Monday(C5)-Application of ACGs in an Israeli Health care System-Primary Care Utilization Bands-Shadmi

Application of ACGs in an Israeli Health care System: Primary Care Utilization Bands Local calibration of ACGs to account  for the burden primary care physicians […]

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Leveraging Care Density: A New Way to Measure and Enhance Care Coordination

If optimizing quality of care, clinical outcomes and cost effectiveness is one of your priorities, ensuring your patient population receives comprehensive, coordinated care from their […]

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Video: ACG System Overview

Interested in learning more?View the ACG System Overview    

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 […]

Association of frailty with outcomes of patients undergoing transvenous lead removal for cardiac implantable electronic device infections in the United States

Abstract Background Frailty, marked by reduced physiological resilience, is associated with adverse outcomes in patients undergoing various cardiovascular procedures. The rising incidence of cardiac implantable […]

Evaluating an insurer-based health coaching program: Impact of program engagement on healthcare utilization and weight loss

Abstract Insurers and employers are increasingly offering lifestyle and weight-loss coaching programs; however, few evaluations have examined their effectiveness. Our objectives were to determine whether […]

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Population Health Profiling

This webinar will explore how the ACG System can – and is – being used to support commissioners and those responsible for the management of […]

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Using the ACG System to support population health management in Baltimore city

Presented by: Melissa Sherry, MPH, CPH

Director, Population Health Innovation and Transformation, Johns Hopkins HealthCare

This webinar presents a case study of the use of the ACG System to address the needs of a high risk, low income population in Baltimore City.

Adjusted Clinical Groups as a risk assessment model for healthcare resource allocation

Rev Med Chil 142:153-160. Published in Spanish. Departamento de Desarrollo Estratégico, Ministerio de Salud. Santiago de Chile BACKGROUND: There is increasing interest in the study […]

Primary health care use from the perspective of gender and morbidity burden

BMC Womens Health 14:145. University of Zaragoza, Zaragoza, Spain; Aragon Health Sciences Institute, Zaragoza, Spain BACKGROUND: Sex and gender can interact to contribute to differences […]

Have we left some behind? Trends in socio-economic inequalities in breastfeeding initiation: a population-based epidemiological surveillance study

Can J Public Health 105:e362. Manitoba Centre for Health Policy, Winnipeg, MB, Canada OBJECTIVES: Breastfeeding is associated with improved health. Surveillance data show that breastfeeding […]

Comorbidity as a predictor of health services utilization and mortality in patients with diabetes

Gac Sanit 29:10-14. Published in Spanish. Universidad de Zaragoza, Zaragoza, España; Dirección General de Planificación y Aseguramiento, Zaragoza, España; Grupo de Investigación en Servicios Sanitarios […]

Patient sharing and quality of care: measuring outcomes of care coordination using claims data

Med Care 53:317-323. Johns Hopkins University, Baltimore, MD, USA BACKGROUND: With the goal of improving clinical efficiency and effectiveness, programs to enhance care coordination are […]

Children’s health care use in the Healthy Kids Program

Pediatrics 100:947-953. Department of Pediatrics, University of Florida, Gainsville, FL, USA BACKGROUND: In 1990, the Florida Legislature established the Florida Healthy Kids Corporation to implement […]

Effect of socioeconomic status on hepatocellular carcinoma incidence and stage at diagnosis, a population-based cohort study

Liver Int. University of Toronto, Toronto, ON, Canada; Cancer Care Ontario, Toronto, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Ontario Institute for Cancer […]

Do pediatric patients who receive care across multiple health systems have higher levels of repeat testing?

Popul Health Manag. Intermountain Healthcare, Salt Lake City, UT, USA; University of Minnesota , Minneapolis, MN, USA; Children’s Hospitals and Clinics of Minnesota , Minneapolis, […]

Are family physicians comprehensively using electronic medical records such that the data can be used for secondary purposes?

A Canadian perspective. BMC Med Inform Decis Mak 15:67. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; University Health […]

Relationship between efficiency and clinical effectiveness indicators in an adjusted model of resource consumption: a cross-sectional study

BMC Health Serv Res 13:421. Institut Universitari d’investigació en Atenció Primària Jordi Gol, Barcelona, Spain BACKGROUND: Adjusted clinical groups (ACG®) have been widely used to […]

Renewing primary care: lessons learned from the Spanish health care system

Health Aff 29:1432-1441. Department of Family Medicine at the Alpert Medical School, Brown University, in Providence, RI, USA From 1978 on, Spain rapidly expanded and […]

Risk adjustment alternatives in paying for behavioral health care under Medicaid

Health Serv Res 36:793-811. UCLA Department of Medicine, Los Angeles, CA, USA OBJECTIVE: To compare the performance of various risk adjustment models in behavioral health […]

The interaction of ethnicity and chronic disease as risk factors for osteoporotic fractures: a comparison in Canadian Aboriginals and non-Aboriginals

Osteoporos Int 17:1358-1368. Department of Medicine, University of Manitoba, Winnipeg, MB, Canada INTRODUCTION: Efforts to develop global methods for absolute fracture risk prediction are currently […]

The duration of ambulatory visits to physicians

J Fam Pract 48:264-271. Institute for Health Policy, Massachusetts General Hospital/Partners HealthCare System, Harvard Medical School, Boston, MA, USA BACKGROUND: The objective of our study […]