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Physician integrated network: a second look

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada This is the second report from Manitoba Centre for […]

Putting your faith in data

Commissioning Success :34-36. No abstract. Article a PDF.

Does surgical setting or wait-time incentive improve return to work following knee surgery among injured workers?

Final report to WorkSafeBC. Vancouver, BC, Canada: University of British Columbia. University of British Columbia, Vancouver, BC, Canada; University Health, Toronto, ON, Canada; University of […]

The faces of Medicaid: the complexities of caring for people with chronic illnesses and disabilities

Hamilton, NJ, USA: Center for Health Care Strategies. Center for Health Care Strategies, Hamilton, NJ, USA A complex question has persisted in our minds since […]

Employer purchasing coalitions and Medicaid: experiences with risk adjustment

New York, NY, USA: Commonwealth Fund. Commonwealth Fund, New York, NY, USA Choice among health plans increases patient satisfaction with care and enables families to […]

Clinical and economic features of categories of patients in defined populations

Stockholm, Sweden: Karolinska Institute (doctoral dissertation). Department of Clinical Services, Center for Family and Community Medicine, Karolinska Institute, Stockholm, Sweden This thesis addresses the use […]

Use predictive modeling to improve profitability under cap

National Health Information LLC. Capitation Rates and Data 9:61-65. National Health Information LLC, Atlanta, GA, USA Health plans and capitated provider organizations live or die […]

Health-based risk assessment: risk-adjusted payments and beyond

Washington, DC, USA: AcademyHealth. AcademyHealth, Washington, DC, USA A number of payers across the country, including Medicaid managed care programs, the Medicare+Choice program, some state […]

Cost benefit analysis of pharmaceutical care in a Medicaid population – from a budgetary perspective

J Managed Care Pharm 4:303-308. Nova Southeastern University, Ft. Lauderdale, FL, USA The objective was to evaluate the economic impact of Medicaid pharmaceutical care services […]

Comparing the value of three main diagnostic-based risk-adjustment systems (DBRAS)

Ottawa, ON, Canada: Canadian Health Services Research Foundation. Canadian Health Services Research Foundation, Ottawa, ON, Canada Diagnostic-Based Risk-Adjustment Systems (DBRAS) are now widely used in […]

Using pharmacy information in a decision support system to improve efficient delivery of primary health care

A study focusing on the Swedish national drug register. BMC Health Serv Res 0:A6. Ensolution, Stockholm, Sweden INTRODUCTION: The aim of the project was to […]

Utilización de los grupos clínicos ajustados en un centro de atención primaria español: estudio retrospectivo de base poblacional

Rev Panam Salud Publica 27:49-55. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials, S.A., Barcelona, Spain OBJETIVOS. Evaluar los resultados de la aplicación del […]

Disparities in antipsychotic medication use

Vancouver, BC, Canada: University of British Columbia (masters thesis). University of British Columbia, Vancouver, BC, Canada OBJECTIVES: To examine ethnic and income-related disparities in the […]

Pilot projects carried out in Lithuania and Latvia: quality indicators for high quality PHC performance

ImPrim Report #3. Karlskrona, Sweden: ImPrim. Klaipeda University, Klaipeda, Lithuania Quality improvement of primary health care is the topic requiring attention from all stakeholders  throughout […]

Who is in our hospitals … and why?

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

Kronik: Datafangst fra nyt system kan anvendes både administrativt og sundhedspolitisk

Ugeskrift for Laeger 176:380-381. Published in Danish. Syddansk University, Odense, Denmark

ACG System Predictive Models Overview

This document provides a high-level overview of how the predictive models within the Johns Hopkins Adjusted Clinical Groups® (ACG) System are designed and the factors […]

Morbidity Burden in Persons with Multiple Chronic Conditions

Morbidity Burden in persons with Multiple Chronic Conditions and Identification of inequitable resource use in Israel Dr. Efrat Shadmi Faculty of Social Welfare and Health […]

Application of ACGs to Medical Claim Records in Japan

Tokyo Medical and Dental University Application of the ACG System to Medical Claim Records in Japan Koichi Kawabuchi

Tuesday-Utilization-Chang

Johns Hopkins ACG System Consistent High Users: Characteristics and Identification Hsien-Yen Chang, PhD. Research Associate

Tuesday-Keynote III-Weiner

Johns Hopkins ACG System Risk Adjustment and Predictive Modeling in Health Reform Jonathan Weiner

Monday-Care Coordination I-Pollack

Johns Hopkins ACG System Innovations in Measuring and Managing Care Coordination Craig Pollack, MD, MHS

The future of integrated care in the NHS

The King’s Fund The Future of Integrated Care in the NHS Professor Chris Ham Chief Executive  

Monday(P1)-A New Day in Population Health Management: Innovations in Risk Adjustment and Predictive Modeling-Weiner

A New Day in Population Health Management: Innovations in Risk Adjustment and Predictive Modeling Welcome and Opening Remarks  Jonathan P. Weiner, DRPH Professor and CEO […]

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Reducing Readmissions

Is your hospital or health system interested in reducing readmissions? Turning data points into actionable insights is key to understanding and addressing the drivers of readmission rates. Learn more in this step-by-step instructional video.

High-Density Lipoprotein Cholesterol and Cause-Specific Mortality in Individuals Without Previous Cardiovascular Conditions

BACKGROUND The prognostic importance of high-density lipoprotein cholesterol (HDL-C) as a specific risk factor for cardiovascular (CV) disease has been challenged by recent clinical trials […]

Case Study: Johns Hopkins Community Health Partnership: A model for transformation

Abstract To address the challenging health care needs of the population served by an urban academic medical center, we developed the Johns Hopkins Community Health […]

Evidence on multimorbidity from definition to intervention: An overview of systematic reviews

Abstract The increasing challenge of multiple chronic diseases (multimorbidity) requires more evidence-based knowledge and effective practice. In order to better understand the existing evidence on […]

Parenchymal hyperdensity on C-arm CT images after endovascular therapy for acute ischaemic stroke predicts a poor prognosis

ABSTRACT   AIM To investigate whether hyperdense areas (HDAs) observed after endovascular treatment on multisection computed tomography (CT) are related to outcome. MATERIALS AND METHODS Data on […]

Emergency Department Use: Common Presenting Issues and Continuity of Care for Individuals With and Without Intellectual and Developmental Disabilities

Abstract This population-based cohort study examined the relationship between level of continuity of primary care and subsequent emergency department (ED) visits for adults with (n = 66,484) […]

Prediction Accuracy With Electronic Medical Records Versus Administrative Claims

Abstract Objective:  The objective of this study was to evaluate the incremental predictive power of electronic medical record (EMR) data, relative to the information available […]

Population segmentation based on healthcare needs: a systematic review

Abstract Background Healthcare needs-based population segmentation is a promising approach for enabling the development and evaluation of integrated healthcare service models that meet healthcare needs. […]

Incidence of Hospitalizations and Emergency Department Visits for Herpes Zoster in Immunocompromised and Immunocompetent Adults in Ontario, Canada, 2002-2016

Abstract BACKGROUND Immunocompromised adults are at increased risk of herpes zoster (HZ) infection and related complications. We aimed to assess the incidence of hospital-attended HZ […]

Association Between Dysphagia and Inpatient Outcomes Across Frailty Level Among Patients ≥ 50 Years of Age

Abstract Frail patients may have heightened risk of dysphagia, a potentially modifiable health factor. Our aim is to examine whether the relationship between dysphagia and […]

Multimorbidity as a predictor of health service utilization in primary care: a registry-based study of the Catalan population

Abstract Background Multimorbidity is highly relevant for both service commissioning and clinical decision-making. Optimization of variables assessing multimorbidity in order to enhance chronic care management […]

Looking across health and healthcare outcomes for people with intellectual and developmental disabilities and psychiatric disorders: population-based longitudinal study

Abstract Background Intellectual and developmental disabilities (IDDs) and psychiatric disorders frequently co-occur. Although each has been associated with negative outcomes, their combined effect has rarely […]

Trends in prevalence of chronic disease and multimorbidity in Ontario, Canada

Abstract BACKGROUND New case-mix tools from the Canadian Institute for Health Information offer a novel way of exploring the prevalence of chronic disease and multimorbidity […]

Assessing the Population-Level Correlation of Medication Regimen Complexity and Adherence Indices Using Electronic Health Records and Insurance Claims

Abstract BACKGROUND Nonadherence to medication regimens can lead to adverse health care outcomes and increasing costs. OBJECTIVES To (a) assess the level of medication complexity […]

Direct cost of Parkinson’s disease in a health system with high judicialization: evidence from Colombia

Abstract Objective To estimate all-claims-all-conditions expenditures paid for by health plans for patients suffering from Parkinson´s disease (PD). Methods Using administrative claims data from two […]

Partial nephrectomy in frail patients: Benefits of robot-assisted surgery

Abstract Background To compare the effect of robot-assisted (RAPN) vs. open (OPN) partial nephrectomy on short-term postoperative outcomes and total hospital charges in frail patients […]

Controller Medication Use and Exacerbations for Children and Adults With Asthma in High-Deductible Health Plans

Abstract Importance High-deductible health plans (HDHPs) are increasingly common and associated with decreased medication use in some adult populations. How children are affected is less […]

How long does it take patients to find a new primary care physician when theirs retires: a population-based, longitudinal study

Abstract Background The retirement of a family physician can represent a challenge in accessibility and continuity of care for patients. In this population-based, longitudinal cohort […]

High prevalence of comorbidities at diagnosis in immigrants with multiple sclerosis

Abstract Background Multiple sclerosis (MS) has been associated with certain comorbidities in general population studies, but it is unknown how comorbidity may affect immigrants with […]

Primary Care Continuity andWait Times to Receiving Breast Cancer Chemotherapy: A Population-Based Retrospective Cohort Study Using CanIMPACT Data

Abstract Background Wait times to chemotherapy are associated with morbidity and mortality in breast cancer patients; however, it is unclear how primary care physician (PCP) continuity […]

Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes

Abstract Objective To determine the association between directly measured physical activity and hospitalisation, intensive care unit (ICU) admission, ventilation and mortality rates in patients with […]

Matching Special Olympics registration data with administrative health databases: Feasibility and health status differences in children and youth with IDD

Abstract Background Children and youth with intellectual and developmental disabilities (IDD) experience health disparities. What is unknown is if data collected from children and youth […]

Association Between Frailty, 30-day Unplanned Readmission and Mortality After Hospitalization for Heart Failure: Results From the Nationwide Readmissions Database

Abstract Objectives: This study examined how frailty in traditional risk-adjusted models could improve the predictability of unplanned 30-day readmission and mortality among heart failure patients. […]

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 […]

Evaluation of the Impact of a Coordinated Intervention Model for Complex Older Patients with Dementia

Abstract Introduction: Person centred care planning and models of care coordination across levels of care reduce fragmentation and unnecessary resource use. Our objectives were to […]

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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Risk adjusted resource allocation in Sweden

Presented by:Andreas Johansson, M.Sc., Founder of Ensolution

Comparison of health care needs of child family members of adults with alcohol or drug dependence versus adults with asthma or diabetes

J Dev Behav Pediatr 35:282-291. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA OBJECTIVE: To compare the health problems, preventive care utilization, and […]

Prevalence of depression in adults with type 2 diabetes in the Basque Country: relationship with glycaemic control and health care costs

BMC Public Health 14:769. Basque Institute for Healthcare Innovation, Barakaldo, Spain BACKGROUND: The aim of the study was to estimate the prevalence of depression in […]

Data resource profile: Pathways to Health and Social Equity for Children (PATHS Equity for Children)

Int J Epidemiol 43:1438-1449. Manitoba Centre for Health Policy, Winnipeg, MB, Canada The PATHS Data Resource is a unique database comprising data that follow individuals […]

Incidence of severe hypoglycaemic episodes in patients with type 2 diabetes in the Basque country: impact on healthcare costs

BMC Health Serv Res 15:207. Basque Institute for Healthcare Innovation, Barakaldo, Spain; Osakidetza, Basque Health Service, Erandio, Spain; University of Deusto, Bilbao, Spain BACKGROUND: Hypoglycaemia […]

Variability in potentially preventable hospitalisations: an observational study of clinical practice patterns of general practitioners and care outcomes in the Basque Country (Spain)

BMJ Open 5:e007360. Osakidetza Basque Health Service, Erandio, Bizkaia, Spain; University of Deusto, Bilbao, Spain OBJECTIVES: To explain the variability in the frequency of potentially […]

Outcomes among patients discharged from the emergency department with a diagnosis of peripheral vertigo

Ann Neurol 79:32-41. University of Toronto, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronot, ON, Canada; Institute of Health Policy, Management and Evaluation at the […]

Evaluation of an innovative program to improve outcomes among military beneficiaries with diabetes

Nurs Econ 33:271-280. University of Texas at Tyler, Tyler, TX, USA; Texas A&M University Health Science Center, Bryan, TX, USA Patients with Type 2 Diabetes […]

Health administrative data can be used to define a shared care typology for people with HIV

J Clin Epidemiol 68:1301-1311. Bruyère Research Institute, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Institute for Clinical Evaluative Sciences, Ottawa, ON, Canada; Ottawa […]

Trends in relative survival in patients with a diagnosis of hepatocellular carcinoma in Ontario: a population-based retrospective cohort study

CMAJ Open 3:E208-E216. University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research/Cancer Care Ontario, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, […]

Prevalence and costs of chronicity and multimorbidity in the population covered by the Basque public telecare service

An Sist Sanit Navar 36:429-339, Published in Spanish. Centro de Salud Astrabudua, Erandio, Spain BACKGROUND: The public telecare service in the Basque Autonomous Community (betiON) […]

Medication, diagnostic, and cost information as predictors of high-risk patients in need of care management

Am J Manag Care 15:41-48. Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA OBJECTIVE: To contrast the advantages and limitations of using medication, […]

Preventive screening of women who use complementary and alternative medicine providers

J Womens Health 18:1133-1143. Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA BACKGROUND: Many women use […]

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, […]