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Options for Concurrent Risk Assessment

DST Health Solutions Options for Concurrent Risk Assessment Amy Salls

Monday(C2)-Steep Increase of Registered Diagnosis Due to New Primary Care Funding Model-Martin Fredriksson

Steep Increase of Registered Diagnosis Due to New Primary Care Funding Model —Martin Fredriksson Region Västra Götaland Medical Advisor at Healtcare Department M.D. Ph.D.

Wednesday(P4)-Population Health Emerging Risk-Medscheme

Population Health Emerging Risk-Medscheme

PREDICTING HEALTHCARE COSTS IN VENETO REGION WITH ACG SYSTEM: VALIDATION AND COMPARISON OF DIAGNOSIS-BASED AND DRUG-BASED MORBIDITY GROUPS IN A NORTHERN ITALIAN POPULATION 

F. Avossa, 1, M.C. Corti, 2 , E. Schievano1, C. Abrams, 3 , N. Alba,  4 , S. Elvini, 5 , P. Gallina,  5, C. […]

Cost Risk Scores: Amy Salls, DST Health Solutions

ACG System The Johns Hopkins ACG® System Cost Risk Models Amy Salls

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The ACG System and Public Health

Joshua Sharfstein, MD, Associate Dean of the Office of Public Health Practice & Training, Johns Hopkins Bloomberg School of Public Health and former Secretary of […]

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Provider Profiling and Engagement Case Study – Payer

Johns Hopkins HealthCare (JHHC), the managed care arm of Johns Hopkins, created Provider Profile reports leveraging outputs from the Johns Hopkins ACG System to build a comprehensive Provider Engagement program.

Incident atrial fibrillation in the emergency department in Ontario: a population-based retrospective cohort study of follow-up care

CMAJ Open 3:E182. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada BACKGROUND: Continuity of care has been shown to […]

Comprehensive preventive care assessments for adults with intellectual and developmental disabilities in Ontario – Part 2: 2003-2014

Objective To determine if there has been an increase in preventive care among adults with IDD as a result of the publication of the Canadian […]

Association between method of pelvic organ prolapse repair involving the vaginal apex and re-operation: a population-based, retrospective cohort study

Abstract Introduction and hypothesis Vaginal apical suspension is essential for the surgical treatment of pelvic organ prolapse (POP). We aim to evaluate whether the method […]

Patient-reported symptoms following mastectomy alone or lumpectomy plus radiation for early stage breast cancer: a cohort study

Abstract Purpose Studies examining symptom differences between surgeries for breast cancer patients rarely incorporate the effects of adjuvant treatment choice. We sought to understand differences […]

Rapid repeat pregnancy among women with intellectual and developmental disabilities: a population-based cohort study

Abstract   BACKGROUND Rapid repeat pregnancy within 12 months of a live birth is associated with adverse perinatal outcomes. We evaluated the risk for rapid […]

Comparing Survey-Based Frailty Assessment to Medicare Claims in Predicting Health Outcomes and Utilization in Medicare Beneficiaries

Abstract   Objectives To assess two models for the prediction of health utilization and functions using standardized in-person assessments of frailty and administrative claims-based geriatric […]

Association of Care Management Intensity With Healthcare Utilization in an All-Condition Care Management Program

ABSTRACT Objectives: To identify care needs among Medicaid and Medicare patients in an all-condition care management program involving case managers (CMs) and community health workers (CHWs), […]

One-Year Mortality After Emergency Department Visit for Nonfatal Opioid Poisoning: A Population-Based Analysis

Abstract Study objective We aim to characterize the incidence and risk factors for opioid-related and all-cause mortality in the year after an emergency department (ED) […]

Colonoscopy resource availability and its association with the colorectal cancer diagnostic interval: A population‐based cross‐sectional study

Abstract Background Colonoscopy is a key resource used to diagnose colorectal cancer (CRC). This study evaluated the relationship between colonoscopy availability and the length of […]

Variation in care of patients with elderly-onset inflammatory bowel disease in Ontario, Canada: A population-based cohort study

Abstract Background Variation in health care, when not based on patient preference, may result in poorer care. We determined whether variation in health services utilization, […]

Mental Health Services Provision in Primary Care and Emergency Department Settings: Analysis of Blended Fee-for-Service and Blended Capitation Models in Ontario, Canada

Abstract Treating mental illnesses in primary care is increasingly emphasized to improve access to mental health services. Although family physicians (FPs) or general practitioners are […]

Impact of Frailty on Clinical Outcomes after Carotid Artery Revascularization

Abstract Objectives : Frailty has been increasingly recognized as an important risk factor for vascular procedures. To assess the impact of frailty on clinical outcomes and […]

Health Status of Females Who Experience Incarceration: A Population-Based Retrospective Cohort Study

Abstract Background People who experience incarceration have poor health across a variety of indicators, but we lack population-level data on the health of females in […]

Concurrent hiatal hernia repair and bariatric surgery: outcomes after sleeve gastrectomy and Roux-en-Y gastric bypass

Abstract Background Hiatal hernias are often repaired concurrently with bariatric surgery to reduce risk of gastroesophageal reflux disease–related complications. Objectives To examine the association between […]

Explanatory Ability of the ACG System Regarding the Utilization and Expenditure of the National Health Insurance Population in Taiwan—A 5-year Analysis

ABSTRACT Background The adjusted clinical group (ACG) is a diagnosis-based case-mix adjustment system, which has been widely evaluated in several countries other than Taiwan. The […]

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 […]

Predicting Future Health Risk in COPD: Differential Impact of Disease-Specific and Multi-Morbidity-Based Risk Stratification

Abstract Objective Multi-morbidity contributes to mortality and hospitalisation in COPD, but it is uncertain how this interacts with disease severity in risk prediction. We compared […]

A Population-Based Analysis of Long-Term Outcomes Among Older Adults Requiring Unexpected Intensive Care Unit Admission After Cancer Surgery

Abstract Background High-intensity cancer surgery is increasingly common among older adults. However, these patients are at high-risk for unexpected intensive care unit (ICU) admissions after […]

Pain and haemorrhage are the most common reasons for emergency department use and hospital admission in adults following ambulatory surgery: results of a population-based cohort study

Abstract Background Advances in healthcare delivery have allowed for the increase in the number of ambulatory surgery procedures performed in Canada. Despite these advances, patients […]

Intensive Use of Forensic Inpatient Services by People with Intellectual and Developmental Disabilities in Ontario, Canada: Prevalence and Associated Characteristics

Abstract Background People with intellectual/developmental disabilities (IDD) are reportedly intensive users of forensic inpatient services. Methods Using administrative data, we identified people with and without […]

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 […]

The impact of frailty on adjuvant treatment in patients with head and neck free flap reconstruction—A retrospective study using two independent frailty scores

Abstract Objectives Reconstructive surgery may result in prolonged postoperative recovery, especially in frail patients, which in turn may impact delivery of adjuvant therapy. To date, […]

Health Care Utilization among Adult Survivors of Childhood and Adolescent Cancer in Ontario

Abstract Survivors of childhood and adolescent cancers are at increased risk for late effects including subsequent cancer, cardiotoxicities, and poor psychosocial health. Few studies have […]

Differences in health care costs between two social health support programs: findings from a randomized social health integration pilot program

Abstract Introduction More health systems are implementing strategies to understand and address patient social health, also known as social health integration. We examine the impact […]

Incidence of Respiratory Syncytial Virus-Associated Hospitalization Among Adults in Ontario, Canada, 2017–2019

Abstract Background Respiratory syncytial virus (RSV) causes substantial morbidity and mortality among adults. Given recent RSV vaccine authorizations, data on groups at highest risk are […]

Healthcare utilization patterns and costs related to neurofibromatosis 1 in Ontario, Canada

Abstract Background and objectives Neurofibromatosis type 1 (NF1) is a multisystemic disease, characterized by cutaneous manifestations and peripheral nerve sheath tumors. Patients also have a […]

The effect of frailty on early postoperative outcomes of lobectomy for lung cancer in older adults – A United States National Retrospective Cohort Study

Abstract Introduction Pulmonary lobectomy represents the primary curative treatment for lung cancer in older adults, yet frailty’s impact on critical early postoperative outcomes remains inadequately […]

Comorbidities and Healthcare Utilization in 4197 Patients With Prurigo Nodularis in Israel: A Cross-Sectional Population-Based Analysis

ABSTRACT Background Prurigo nodularis patients face a significant burden of comorbidities, necessitating a comprehensive approach to care. We aimed to explore the association between prurigo […]

Improving models to predict care utilization using machine learning: a retrospective observational study

Abstract Background: Use of artificial intelligence (AI) and machine learning (ML) tools is now common in the advancement of healthcare services and clinical risk estimation. Legacy […]

Readmissions Infographic

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

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

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

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Supporting Clinical Activities

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

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Predictive Modelling in Action

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

Do physicians who diagnose more mental health disorders generate lower health care costs?

J Fam Pract 49:305-310. University of Rochester School of Medicine, New York, NY, USA BACKGROUND: Underrecognition and undertreatment of mental health disorders in primary care […]

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

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

Health information exchange and the frequency of repeat medical imaging

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

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

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

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

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

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

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

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

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

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

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

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

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

Risk-adjusted Medicare capitation rates using ambulatory and inpatient diagnoses

Health Care Financ Rev 17:77-99. Johns Hopkins School of Public Health, Baltimore, MD, USA Researchers at The Johns Hopkins University (JHU) developed two new diagnosis-oriented […]

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

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

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

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

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

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

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

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

Formal risk adjustment by private employers

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

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

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

HMO family physicians: men and women differ in their work

HMO Pract 9:155-161. Group Health Cooperative of Puget Sound, Seattle, WA, USA OBJECTIVE: The goal was to identify differences in the type of work and […]

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

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

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

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

Case-mix index and length of hospitalization

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

ACG case-mix system aids contract assessment, improves performance

Data Strateg Benchmarks 4:21-26. The ABCs of ACGs. Adjusted clinical groups, or ACGs, a risk adjustment system developed by Baltimore-based Johns Hopkins University, are being […]

Realigning incentives in fee-for-service Medicare

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

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

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

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

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

Ambulatory care casemix measures

J Gen Intern Med 10:162-170. HSR&D Field Program, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA No abstract PMID: 7769475

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

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

The effect of acupuncture utilization on healthcare utilization

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

A systematic review of health care efficiency measures

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Measuring medical productivity to gauge the value of Medicare

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

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

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

Determinants of buprenorphine treatment for opioid dependence

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Risk distribution and risk assessment among enrollees in Washington state’s Medicaid SSI population

Hamilton, NJ, USA: Center for Health Care Strategies. Center for Health Care Strategies, Hamilton, NJ, USA Washington state began enrolling Medicaid SSI (low income, disabled) […]

Risk adjustment and rate setting methods in public programs

A report to legislature. St. Paul, MN, USA: Minnesota Department of Health. Health Economics Program, Minnesota Department of Health, St. Paul, MN, USA The 1995 […]

Updating and calibrating the Johns Hopkins University ACG/ADG risk adjustment method for application to Medicare risk contracting

Final report to Health Care Financing Administration. Baltimore, MD, USA: Johns Hopkins University. Johns Hopkins University, Baltimore, MD, USA The Balanced Budget Act (BBA) of […]

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

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

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

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

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

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

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

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

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

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

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

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

Adjusted Clinical Groups (ACG) and co-morbidity

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

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

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

Leicester City CCG Case Study 3

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