When talking about population health, discussion often centers on the groups of patients with the highest health care utilization levels, for obvious reasons: those using more health care generate higher costs. However, there is an equally important group of patients that often goes unnoticed: non-utilizers, or patients who have not used their medical benefits for a specific period of time. This seemingly inconspicuous patient group actually contains a wealth of invaluable population health information waiting to be discovered. This is where the ACG System comes in.
The ACG System makes it easy to locate non-utilizers, thanks to its Resource Utilization Band (RUB) categories. RUBs categorize patients into similar levels of resource use and comorbidity, from 0 to 5, with 5 being the highest level of health care utilization. Any patients with a RUB level of 0 are considered non-utilizers. In ACG System sample groups, up to 22% of a population falls into this category in a given year.
Beyond identifying the segment of a population with RUB 0, the ACG System can help users dive deeper into the nuances of the data, revealing key insights along the way. For instance, we know that in the US, patients with Medicare coverage are encouraged to complete an annual wellness visit; similarly, all adults should be screened periodically for depression and hypertension, and anyone over age 45 should be assessed regularly for diabetes and lipid disorders. The ACG System can identify anyone in RUB 0 who meets these age or insurance coverage criteria so that providers can offer preventative visits that should have occurred. Similarly, the ACG System can easily identify patients in RUB 0 who are also filling medications for chronic conditions, such as hypertension or depression. These patients could also benefit from more frequent, preventative care.
Ultimately, while patients who aren’t utilizing health care might seem at first glance to be the lowest risk group in a population, they could actually be high-risk patients in the making. The ACG System’s analytic tools can reveal this nuanced reality, helping users identify high-risk patients earlier. With the help of the ACG System, users can put these insights to work and provide crucial preventative care to a patient group that might otherwise go unnoticed.