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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, […]

Adverse cardiac events in older patients receiving venlafaxine: a population-based study

J Clin Psychiatry 75:e552-e558. Sunnybrook Health Sciences Centre, Toronto, ON, Canada OBJECTIVE: Venlafaxine is a commonly prescribed antidepressant, but whether its noradrenergic effects impart increased […]

Federal disaster declarations and denials: analyzing spatial equity in the implementation of the Stafford Act

Tampa, FL, USA: University of South Florida (doctoral dissertation). University of South Florida, Tampa, FL, USA Federal disaster declarations are authorized by the president under […]

VG primarvard i for hallande till riksrevisionens rapport “primaryvardens styrning – efter behov eller efterfragan?”

Vanersborg, Sweden: Vastra Gotalandsregionen. Published in Swedish. Vastra Gotalandsregionen, Vanersborg, Sweden

Conference Welcome – Amy Salls

ACG Training Conference Welcome Amy Salls Director, Population Health Strategy DST Health Solutions  

01 Welcome & Introduction – Alan Thompson

Alan Thompson Director of User Support Johns Hopkins HealthCare Solutions

02 Population Health Management – Ming Tang

Ming Tang Director of Data & Analytics Data, Analysis and Insights Service (DAIS) NHS England and NHS Improvement

Welcome & Introduction – Jonathan Weiner & Mark Cochran

Welcome and Introduction Jonathan Weiner Professor and Director, Center for Population Health IT     Mark Cochran Executive Director, Johns Hopkins HealthCare Solutions

03 Complex Case Management Programme – Jim O’Donnell

Dr. Jim O’Donnell Slough Locality Lead, NHS East Berkshire CCG Frimley ICS Clinical Commissioning Lead EBCCG Reducing Variation Workstream Clinical Lead Deputy Chair Slough Wellbeing […]

04 Advances in Population Health Sharing Insights – GE Healthcare & Sollis

Pat Nichols, GE Sarah Ouanhnon, GE Graham Head, Sollis

05 From Cake-mix to Case-mix – David Shepherd

Dr. David Shepherd GP & HNN Lead Leicester City CCG

06 Working Together to Deliver Population Health – Chris Roche

Chris Roche Information Manager Gloucestershire STP Please note: There are three buttons below. One will link to the presentation slides. One will link to a […]

07 Using Predictive Models to Support Case Finding – David Brown & Peter Glover

Dr. David Brown Peter Glover Farnham Integrated Care Services

08 Risk-Adjusted Resource Allocation in Leicester – Mark Pierce

Mark Pierce Senior Strategy & Implementation Manager Leicester City CCG

01 David Shephard – Casemix Adjustment in Primary Care

Dr. David Shephard GP and Health Need Neighbourhood Chair, Leicester South

Session 1: Brad Myers – Version 12 Supplementary Data

Version 12 Supplementary Medical Services Brad Myers DST Health Solutions  

01 Karen Kinder Welcome Presentation

ACG System Dr. Karen Kinder Executive Director

New Medicaid Enrollees with Highest Care Needs

The ACG System can help identify new Medicaid enrollees with high care needs.

COVID-19: Marathon Health Outreach

By leveraging the Johns Hopkins ACG System, Marathon Health was able to offer outreach and options to individuals identified as a higher risk of contracting or experiencing complications as a result of COVID-19.

Recalibration of Predictive Models

This short report provides details of the third recalibration of the predictive models within the ACG System for the UK.

Reducing Disparities in the Delivery of Primary Care

This report details the work of 2020 Starfield award winner Discovery Health to demonstrate, using the Johns Hopkins ACG System, the impact of improving primary care utilization.

Session 2: Don McGaw – Version 12 JHU ED Visit Classification

Version 12 JHU ED Visit Classification Don McGaw DST Health Solutions  

Session 1: Mitchell – Assessing Patient Morbidity: Risk Factors

DST Health Solutions Assessing Patient Morbidity: Risk Factors Anna-Marie Mitchell Senior Product Consultant

02 David Colin Thome – Primary Care Home

The Primary Care Home (PCH) David Colin-Thomé Independent Healthcare consultant Visiting Professor Manchester Business School Former General Medical Practitioner and National Clinical Director for Primary […]

Keynote I – Jonathan Weiner – Analytics & Big Data in Support of the Social and Medical Health of Populations

Analytics & Big Data in Support of the Social and Medical Health of Populations: The ACG System Today and Tomorrow Jonathan P. Weiner, DrPH Professor […]

Session 3: Anna-Marie Mitchell – Version 12 Laboratory Measures

Version 12 Laboratory Measures Anna-Marie Mitchell Senior Analytic Product Consultant DST Health Solutions  

Session 2: Myers – Hospitalization Risk

DST Health Solutions Hospitalization Models Brad Myers Predictive Modeling Product Consultant

03 Nick Harding – Challenges Faced By Primary Care

NHS Sandwell and West Birmingham Clinical Commissioning Group The challenges faced by primary care and the need for good quality information Professor Nick Harding OBE FRCGP […]

Session 4: Amy Salls – Assessing Candidates for Care Coordination

Assessing Candidates for Care Coordination Amy Salls Director, Population Health Strategy DST Health Solutions  

Session 3: McGaw – Care Coordination

DST Health Solutions Care Coordination and Care Density Donald D. McGaw Jr. Client Relations Consultant

Session 4: Salls – Assessing Candidates for Care Management

DST Health Solutions Assessing Candidates for Care Management Programs Amy Salls Director, Population Health Strategy

Hospitalization Risk Scores: Amy Salls, DST Health Solutions

ACG System DST Health Solutions Hospitalization Models Amy Salls

Session 5: Sokchay Chiv & Kate Hollidge – Catching a Breath Program for COPD

Catching a Breath Program: Implementing and Expanding Clinical Programs Sokchay Chiv Director, Population Health Strategies Meridian Health Plan Kate Hollidge Senior Manager, Population Health Programs […]

05 Lizelle Steenkamp – Segmentation and the Impact of Vitality

Discovery Health Vitality Segmentation and impact of Vitality (Population Health Management) Lizelle Steenkamp

Session 5: DiLorenzo – An Analysis of Risk Scores of Patients with Less Than Twelve Months of Claims History

MVP Health Care Analysis of Risk Scores of Patients with Incomplete Claims History Tyson DiLorenzo, PhD. Manager, Finance & Actuarial Analytics at MVP

Session 6: Brad Myers – Version 12 Opioid Markers

High Risk Opioid Use Markers Brad Myers DST Health Solutions  

06 James Barrett – The Benefits of an Integrated Dataset When Predicting Future Risk

James Barrett Johns Hopkins HealthCare Solutions Johns Hopkins ACG System

Data Validation: Lisa Kabasakalian, DST Health Solutions

ACG System DST Health Solutions The Johns Hopkins ACG® System Data Validation Lisa Kabasakalian

Session 5: Khomenko – Health Questionnaires and Population Risk Indexing

DataSmart Solutions Health Questionnaires and Population Risk Indexing Bernard Khomenko, CEBS Vice President of Client Services

Session 7: Sokchay Chiv & Kate Hollidge – Opioids Among the Masses

Opioids Among the Masses: Using Advanced Analytics to Drive Clinical Programs Sokchay Chiv Director, Population Health Strategies Meridian Health Plan Kate Hollidge Senior Manager, Population […]

07 Alan Thompson – Segmentation: Exploring the Relationship Between Frailty and Other High-Risk Groups

Alan Thompson Johns Hopkins HealthCare Solutions Johns Hopkins ACG System

Assessing the Impact of Incomplete Date: Kelsey Rauch, DST Health Solutions

ACG System DST Health Solutions Patient Identification with Incomplete Data Kelsey Rauch

07a Mark Pierce – Applying the ACG System in Whole Population Management

Leicester, Leicestershire and Rutland Integrated Teams Mark Pierce

07b David Cochrane – Applying the ACG System in Whole Population Management

Conrane International Health Solutions (IHS) Whole Population Management- What to do about it David Cochrane

Session 8: Philip Bruns – Population Health Management for Non-Clinical Analysts

Population Health Management for Non-Clinical Analysts Philip Bruns BenefitFocus  

09 Population Segmentation and Risk Stratification – Kelechi Nnoaham

Kelechi Nnoaham Director of Public Health Cwm Taf Morgannwg University Health Board, Wales

Program Evaluation: Amy Salls, DST Health Solutions

ACG System DST Health Solutions Using The Johns Hopkins ACG® System for Program Evaluation Amy Salls

Session 6: Terrell-Hoxter – The Challenge of Visualizing Diagnostic Conditions in the Population

Lightbeam Health Solutions The Challenge of Visualizing Diagnostic Conditions in the Population Mike Hoxter, Tim Terrell

08 J Pall S Adams – Working Together to Gain Insight

Sollis Working together to gain insight Supporting and enhancing the lives of people in Brighton Jaivir Pall

Session 9: Nathan Cohen – Leveraging Data to Improve Outcomes and Delivery of Care

Leveraging Data to Improve Outcomes and Delivery of Care Nathan Cohen Philips Population Health Management  

Session 1 – Ines Vigil & Martha Sylvia – Achieving Population Health Surveillance with ACG System Outputs

Achieving Population Health Surveillance with ACG System Outputs Ines Vigil MD, MPH, MBA VP, Advanced Analytics Priority Health     Martha Sylvia PhD, MBA, RN […]

10 Features in the Next Version of the ACG System – Steve Sutch

Dr. Steve Sutch Product Management Director Johns Hopkins HealthCare Solutions

Session 6: Sylvia – A Pilot of Using the ACG System with Electronic Medical Record Data to Identify Children with Medical Complexities at the Medical University of South Carolina

Medical University of South Carolina (MUSC) Health Using ACGs in the Electronic Medical Record to Identify Children with Medical Complexities Martha Sylvia, Seray Gardner, Corey […]

09 C Morris S Scobie – Population Health Analytics

NHS – South, Central and West Commissioning Support Unit SCW | CSU Population Health Analytics – from supporting clinical commissioning to shaping New Models of […]

Session 10A: Anna-Marie Mitchell – Assessing Mortality: Ontario Mortality Score

Assessing Mortality: Ontario Mortality Score Anna-Marie Mitchell Senior Analytic Product Consultant DST Health Solutions  

Session 7: Prada – Using the ACG System in Colombia: What Have We Learned About Our Health System?

Universidad Icesi – Proesa Using the ACG System in Colombia: What have we learned about our health system? Sergio I. Prada, PhD Melissa Perez, M.A.

Session 7: Lieberman – Integrating The Johns Hopkins ACG System with Other Proprietary and Non-Proprietary Tools

Mile High Healthcare Analytics Integrating The Johns Hopkins ACG System with Other Proprietary and Non-Proprietary Tools Richard Lieberman

10 David Shepherd – Pin the Tail on the Donkey

Pin the tail on the donkey and other party games David Shepherd

Session 10B: Tyler Boese – Assessing Mortality: Ontario Mortality Risk Score

Assessing Mortality: Ontario Mortality Risk Score Tyler Boese Medica

11 Alan Gwynne – The Magic of Venn Diagrams

Some practical examples of using population profiling and risk stratification within The South Cotswold’s locality Alan Gwynne

Session 8: Hall – Creating Reporting Benchmarks for Provider ACOs

Minnesota Department of Human Services Creating Reporting Benchmarks for Provider ACOs Jackie Sias, Data Analyst Kristofer Hall, Provider Informatics Lead

Session 11: DST Health Solutions Team – Ask the Experts

Ask the Experts DST Health Solutions Team

Session 8: McGaw – Customizing ACG System Output Using Filters and Calculations

DST Health Solutions Customizing ACG Output Using Filters and Calculations Donald D. McGaw Jr. Client Relations Consultant

12 Alan Thompson – Closing Remarks

ACG Johns Hopkins Healthcare Solutions (JHHCS) Reflections on the Day Alan Thompson  

Session 12: Adele Allison – Value-Based Payment

Anatomy of Value-Based Payment Adele Allison Director, Provider Innovation Strategies SS&C Health

Session 9: Khomenko – Confidence in Predictions to Meet Organizational Needs

DataSmart Solutions Confidence in Predictions to Meet Organizational Needs Analytics Driven Solutions Bernard Khomenko, CEBS Vice President of Client Services

Session 1 – Pepa Soriano – ACG System as a key factor for a PHM program

ACG System as a key factor for a PHM program Pepa Soriano Leader of the Population Management Program at Ribera Salud

Session 13: Amy Salls – Total Cost of Care

Total Cost of Care Analytics Amy Salls Senior Director, Analytics SS&C Health

Session 14: Arielle Trzcinski – Advanced Analytics Required to Win, Serve, and Retain Customers

Advanced Analytics Required to Win, Serve, and Retain Customers Arielle Trzcinski Senior Analyst Forrester Research

Session 9: Singal – Pharmacy Value-Based Programs

DST Pharmacy Value Based Programs Rahul Singal, MD Chief Medical Officer

Session 15: Tim Terrell – Storytelling with Exploratory Data

Storytelling with Exploratory Data Tim Terrell Director of Analytics Lightbeam Health Solutions

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