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Specialty use among patients with treated hypertension in a patient-centered medical home

J Gen Intern Med Division of General Internal Medicine and Geriatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA BACKGROUND: Little is known about […]

One-year outcomes associated with using observation services in triaging patients with nonspecific chest pain

Clin Cardiol 37:591-596. Division of Management, Policy and Community Health, University of Texas School of Public Health, Houston, Texas. BACKGROUND: Observation services are provided in […]

Changes in office visit use associated with electronic messaging and telephone encounters among patients with diabetes in the PCMH

Ann Fam Med 12:338-343. Group Health Research Institute, Seattle, WA, USA PURPOSE: Telephone- and Internet-based communication are increasingly common in primary care, yet there is […]

Measuring morbidity in populations: performance of the Johns Hopkins Adjusted Clinical Group (ACG) case-mix adjustment system in Manitoba

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada This study examined the performance of the Johns Hopkins […]

Creating meaningful composite scores for primary care

2015 North American Primary Care Research Group Annual Meeting, October 2015, Cancun, Mexico. Context: Composite scores (CSs) provide a global measure of quality. CS development […]

Long-term risk of heart failure associated with adjuvant trastuzumab in breast cancer patients

2014 American Society of Clinical Oncology Annual Meeting. Abstract 9504. J Clin Oncol 32 (suppl; abstr 9504). University of Toronto, Toronto, ON, Canada; St. Michael’s […]

Is the class half empty? A population-based perspective on socioeconomic status and educational outcomes

IRPP Choices 12:1-30. Manitoba Centre for Health Policy, Department of Community Health Sciences, Faculty of Medicine University of Manitoba, Winnipeg, MB, Canada The purpose of […]

Characteristics of risk adjustment systems. Working Paper Series 2

Gainesville, FL, USA: Institute for Child Health Policy, University of Florida. Institute for Child Health Policy, University of Florida, Gainesville, FL, USA Increasing numbers of […]

Using the ACG case-mix adjustment system to evaluate veteran’s morbidity burdens and medical utilizations in Taiwan

J Healthc Manag 8:67-84. Published in Chinese. Department of Medical Affairs and Planning, Taipei Veterans General Hospital, Taipei City, Taiwan, ROC OBJECTIVES: Veterans have been […]

Performance of risk adjusted capitated systems in allocating a global budget

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Johns Hopkins University, Baltimore, MD, USA Rapidly rising health care costs in the United States have led […]

The Adjusted Clinical Groups (ACGs) system in Osakidetza

Final report (1/05/2003 – 30/04/2003). Vitoria-Gasteiz, Spain: Osakidetza Servicio vasco de salud. Published in Spanish. Osakidetza Servicio vasco de salud, Vitoria-Gasteiz, Spain No abstract

How are Manitoba’s children doing?

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada The health and development of Manitoba’s children were examined […]

Using selected diagnoses to improve the Chilean capitation formula

Greifswald, Germany: Ernst Moritz Arndt University of Greifswald. Ernst Moritz Arndt University of Greifswald, Greifswald, Germany OBJECTIVES: To contribute to the policy discussion of equity […]

Home health services in British Columbia: a portrait of users and trends over time

Home health services in British Columbia: a portrait of users and trends over time. Vancouver, BC, Canada: University of British Columbia. University of British Columbia, […]

The effect of a coordinated care program on uninsured, chronically ill patients

Richmond, VA, USA: Virginia Commonwealth University (doctoral dissertation). Virginia Commonwealth University, Richmond, VA, USA This study explored how being enrolled in a program that both […]

Equity in the use and financing of medicines in British Columbia before and after the move to income-based pharmacare

Vancouver, BC, Canada: University of British Columbia (doctoral dissertation). University of British Columbia, Vancouver, BC, Canada BACKGROUND: In May 2003, the B.C. government introduced an […]

Utilizacion de servicios de salud en atencion primaria del area 11 de Madrid y nivel psicobioquimico de estres y de salud bucodental en su poblacion immigrante y autoctona

Madrid, Spain: Universidad Complutense de Madrid (masters thesis). Published in Spanish. Universidad Computense de Madrid, Madrid, Spain La naturaleza trashumante de la Humanidad le es […]

Developing decision trees to classify patients suited for similar interventions by combining clinical judgments with Leeds Risk Stratification Tool

London, UK: London School of Economics and Political Science. London School of Economics and Political Science, London, UK The objectives of the project are to […]

What is most important: social factors, health selection, and adolescent educational achievement

Soc Indic Res 110:385-414. Department of Community Health Sciences, Faculty of Medicine, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada This paper […]

Case Finding & Population Profiling – Separate Disciplines or Both Sides of the Same Coin?

This award-winning document presented at the 2015 PCSI conference highlights work undertaken with Slough Clinical Commissioning Group in the UK. The work has challenged some […]

Leicester City CCG Case Study 2

 Use of ACG® System output to support practices in participating in a medicines management scheme – STOPP-START

Care Management Program Case Study-Payer

Clalit Health (an integrated delivery system in Israel) used the ACG System to identify high-risk patients for enrollment in a comprehensive complex care management program […]

Case-Mix Information Uses and Health Services Sustainability

Iasist Casemix Information Uses and Health Services Sustainability: A Few Examples From Current Spanish Downturn Mercè Casas Carles Illa

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.

Predictors of hospital stay and home care services use: A population-based, retrospective cohort study in stage IV gastric cancer

Background: Home care services use has been proposed as a means of reducing costs in palliative care by decreasing hospital stay without impacting quality of […]

Albuminuria, Reduced Kidney Function, and the Risk of ST‐ and non–ST‐segment–elevation myocardial infarction

Abstract Background Chronic kidney disease is a recognized independent risk factor for cardiovascular disease, but whether the risks of ST‐segment–elevation myocardial infarction (STEMI) and non–ST‐segment–elevation […]

Correlation between Potentially Inappropriate Medication and Alzheimer’s Disease among the Elderly

Abstract   Purpose This study is conducted to explore the association between potentially inappropriate medication (PIM) and Alzheimer’s disease (AD) among the elderly. Methods We […]

Variation in the health outcomes associated with frailty among home care clients: relevance of caregiver distress and client sex

Abstract Background The identification of contextual factors that modify associations between client frailty and their health and service use outcomes is essential for informed home […]

The Incremental Health Care Costs of Frailty Among Home Care Recipients With and Without Dementia in Ontario, Canada: A Cohort Study

Abstract Objective In this study, we investigated the incremental 1-year direct costs of health care associated with frailty among home care recipients in Ontario with and without […]

Do Incentive Payments Reward The Wrong Providers? A Study Of Primary Care Reform In Ontario, Canada

ABSTRACT Primary care payment reform in the US and elsewhere usually involves capitation, often combined with bonuses and incentives. In capitation systems, providing care within […]

Economic Analysis of Adjuvant Chemoradiotherapy Compared with Chemotherapy in Resected Pancreas Cancer

Abstract Background Population-based survival and costs of pancreas adenocarcinoma patients receiving adjuvant chemoradiation and chemotherapy following pancreaticoduodenectomy are poorly understood. Methods This retrospective cohort study used […]

Incremental healthcare utilisation and costs among new senior high-cost users in Ontario, Canada: a retrospective matched cohort study

Abstract Objectives To describe healthcare use and spending before and on becoming a new (incident) senior high-cost user (HCU) compared with senior non-HCUs; to estimate […]

Diagnostic accuracy of administrative codes for autosomal dominant polycystic kidney disease in clinic patients with cystic kidney disease

Abstract Background The ability to identify patients with autosomal dominant polycystic kidney disease (ADPKD) and distinguish them from patients with similar conditions in healthcare administrative […]

Correlates of non-adherence to breast, cervical, and colorectal cancer screening among screen-eligible women: a population-based cohort study in Ontario, Canada

Abstract Purpose Breast, cervical, and colorectal cancers are cancers that can be detected early through screening. Despite organized cancer screening programs in Ontario, Canada participation […]

Comparing the Predictive Effects of Patient Medication Adherence Indices in Electronic Health Record and Claims-Based Risk Stratification Models

Abstract Multiple indices are available to measure medication adherence behaviors. Medication adherence measures, however, have rarely been extracted from electronic health records (EHRs) for population-level […]

In-Person and Telehealth Ambulatory Contacts and Costs in a Large US Insured Cohort Before and During the COVID-19 Pandemic

Abstract Importance This study assesses the role of telehealth in the delivery of care at the start of the COVID-19 pandemic. Objectives To document patterns […]

Class III Obesity and Other Factors Associated with Longer Wait Times for Endometrial Cancer Surgery: A Population-Based Study

Abstract Objective To evaluate the impact of class III obesity (body mass index >40 kg/m2) on wait times for endometrial cancer surgery in Ontario, as […]

Evaluating the performance of a predictive modeling approach to identifying members at high-risk of hospitalization

Abstract Aims To evaluate the risk-of-hospitalization (ROH) models developed at Blue Cross Blue Shield of Louisiana (BCBSLA) and compare this approach to the DxCG risk-score […]

Impact of Area Deprivation Index on the Performance of Claims-Based Risk-Adjustment Models in Predicting Health Care Costs and Utilization

Abstract Objective Traditionally, risk-adjustment models do not address the characteristics of minority populations, such as race or socioeconomic status. This study aimed to evaluate the […]

Long-term risk of subsequent major osteoporotic fracture and hip fracture in men and women: a population-based observational study with a 25-year follow-up

Abstract Summary The risk of subsequent major osteoporotic and hip fracture following an initial fracture was increased in both sexes over 25 years, with modest […]

Association of Surgical Experience With Risk of Complication in Total Hip Arthroplasty Among Patients With Severe Obesity

Abstract Importance Severe obesity is a risk factor for major early complications after total hip arthroplasty (THA). Objective To determine the association between surgeon experience […]

Outpatient Physical Therapy Use Following Tibial Fractures: A Retrospective Commercial Claims Analysis

Abstract Objective The purpose of this study was to characterize outpatient physical therapy (OPT) use following tibial fractures and examine the variability of OPT attendance, […]

Time since prior fracture affects mortality at the time of clinical assessment: a registry‑based cohort study

Abstract Summary Fractures are associated with increased long-term mortality in patients surviving to undergo baseline DXA. Notably, excess mortality risk does not decline with increasing […]

Impact of Frailty on Hospital Outcomes Among Patients with Lymphoid Malignancies Receiving Autologous Hematopoietic Stem Cell Transplantation in the United States

Abstract Background Frailty could affect outcomes of autologous hematopoietic stem cell transplantation (aHSCT). This study sought to examine the effects of frailty on hospital outcomes […]

Relationship of frailty with excess mortality during the COVID-19 pandemic: a population-level study in Ontario, Canada

Abstract Background There is a paucity of the literature on the relationship between frailty and excess mortality due to the COVID-19 pandemic. Methods The entire […]

Combining Patient Survey Data With Diagnosis Codes Improved Medicare Advantage Risk-Adjustment Accuracy

Abstract Under the current Medicare Advantage (MA) risk-adjustment system, plans are incentivized to report diagnosis codes on enrollees’ medical claims reflecting additional and more severe […]

Primary Care Unattachment; Impact on Mortality, Hospitalizations and Costs

Abstract Background: Primary care attachment, defined as a patient’s formal or informal affiliation with a regular primary care provider, is a cornerstone of many healthcare […]

Trends in Insulin Out-of-Pocket Costs and Use Disparities, 2008-2021

Abstract OBJECTIVE: To assess trends in insulin out-of-pocket (OOP) costs, use, and disparities among commercially insured patients from 2008 to 2021. STUDY DESIGN: Retrospective time […]

Refocusing Algorithmic Fairness on Feature-Level Bias: A Diagnostic Approach Using Dutch EHR Data

Abstract While algorithmic fairness research in healthcare has predominantly focused on disparities in model performance, less attention has been given to the underlying data structures […]

Association between Johns Hopkins Adjusted Clinical Groups risk scores and self-reported outcome measures: an observational study among individuals with complex or long-term conditions in Norway

Abstract Objective:  Investigate the association between Johns Hopkins Adjusted Clinical Groups (ACG) risk scores and low scores in self-reported outcome measures (SROMs) among individuals with […]

Association Between Adoption of Robotic Total Knee Arthroplasty in Canada and Major Surgical Complications

Abstract Background Robotic-assisted total knee arthroplasty (rTKA) is being adopted rapidly, but data on its real-world safety compared with conventional TKA (cTKA) outside specialized centers […]

Bridging the gap: health equity in women’s urologic care across rural settings

Purpose of review Health equity has emerged as a priority in urology, as disparities in access to care and health outcomes are driven by social, […]

Association of Cumulative Proton Pump Inhibitor Use with Prostate Cancer Risk and Outcomes: A Population-Based Cohort Study

Abstract Proton pump inhibitor (PPI) use has been associated with increased prostate cancer risk in case–control and cohort studies of men with a negative prostate […]

Determinants of Failure to Rescue After Pulmonary Resection for Lung Cancer: Insights From a National Inpatient Sample

ABSTRACT Background and Objectives Failure to rescue (FTR), defined as death following a postoperative complication, is an established quality metric; however, national data after pulmonary […]

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 […]