The ACG System and Predictive Modeling

September 7th, 2021
ACG 101
The ACG System and Predictive Modeling

Predictive Modeling is a common statistical technique that is often used to predict future outcomes. The ACG System’s predictive models can help System users gain insights around population and individual predictions, identify a unique population of patients at risk of certain outcomes, and focus on individuals with the greatest need for health intervention or care management.

What makes the ACG System’s predictive models unique?

The ACG System’s predictive models are created using clinical frameworks that are relevant to health professionals and medical leaders. The models are distinguished by their clinical clarity and logic, excellent statistical performance and adaptations and validations across US and international markets. Most importantly, the ACG System’s models go beyond single diseases or care episodes to include whole-patient measures of multimorbidity, frailty and medication use, giving a more holistic view of what’s really going on in a population.

How the Predictive Models Work

The ACG System contains a variety of well-validated models that can help predict future costs, hospitalizations, readmissions, and pharmacy-specific outcomes. System users across the globe use these model outputs to understand future expenditures, gain insight into emerging risk areas and identify and manage patients by risk tier.

Most ACG System customers have access to all of our predictive models, including pharmacy-focused models when pharmacy data is available. Models most commonly applied by System users include:

  • Total cost
  • Pharmacy cost
  • Persistent high utilizer
  • Inpatient hospitalizations
  • ICU hospitalizations
  • Readmissions

The Benefits of Using ACG Models

Predictive Models calibrated for case identification can provide leaders with a suite of tools to estimate future resource use based on the casemix of the enrolled population, which offers an improvement over more traditional models. The ACG System’s prospective cost models are particularly useful for risk stratification, understanding future costs and when setting premium rates in the underwriting process. Benefits of the ACG System’s prospective cost models include:

  • Automated risk assessment on every member offers greater efficiency
  • Objective, reproducible method favored by regulators and state rate-setting agencies due to its high level of consistency
  • Analyses details can be used for sales and marketing efforts

Ultimately, the ACG System’s predictive models dive below the surface of your data, revealing essential context and nuances that can help you and your team make more effective decisions to minimize risk and predict outcomes. With the ACG System’s suite of predictive modeling tools, you can proactively identify and address challenges, rather than simply reacting to them.


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