Are you a provider, payor or population health organization looking for a quick tune-up to your existing strategy and planning? Then look no further. In this series of posts, we’ll be sharing 7 quick wins the ACG System offers its users.
Any patient population can be divided into Adjusted Clinical Groups (ACGs), where each group represents a different level of expected health care need. While patients within a single ACG are similar in terms of health care need, the truth is there can be a wide variation in costs between patients in the same health category. Some ACG System users see up to 4-fold cost variation within a single category. Determining the reason behind this variation can be tricky, but is critical to uncover challenges related to patient care and provider efficiency. Some discrepancy may be due to natural variation, while others may be caused by inefficiency in care, a breakdown in the health care system, or challenges in patient access and self-management. The ACG System can help identify what is driving this variation so that these factors can be addressed properly.
The ACG System can easily distinguish variation within patient groups by allowing users to examine prior costs and clinical attributes for patients in a particular ACG. The System can also determine which services are associated with these costs (emergency care, for example) to help users understand what led certain patients to be in the specific ACG in the first place. Importantly, with ACG System analytics tools, users can also see non-morbidity-related factors that may be contributing to variation between patients, such as patient behavior, over-provision of services, care coordination challenges, barriers to access and more. ACG System users commonly deep-dive into subsets of patients with a moderate-to-high level of complexity, patient subsets with costs 2-3x more than the group average, or patients greater than two standard deviations from mean cost.
With a few simple steps, users of the ACG System can identify and diagnose variation in their specific patient groups, catching any potentially unnecessary variation in cost. Knowing what variations exist and why they are there can help providers streamline procedures and services, increase access to care, and ultimately improve the care patients receive and reduce health care costs. And that’s a winning combination, if you ask us!
Quick Win #1: Optimize Enrollment in Existing Programs
Quick Win #2: Streamline Medication Needs
Quick Win #3: Effectively Manage Multimorbidity
Quick Win #4: Maximize Primary Care Provider (PCP) Usage
Quick Win #5: Reduce Avoidable Emergency Department Visits
Quick Win #6: Optimize Existing Programs
While these techniques are focused on US customers, we have parallel suggestions for international ACG System users, developed by our team based in Europe with support from one of our UK users, Sollis. Please contact us for more information.