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Predicting the financial risks of seriously ill patients

Sacramento, CA, USA: California Health Care Foundation. In this paper, a Medical Productivity Index (MPI) is proposed as such a metric to capture the value […]

Empirical studies in the economics of health insurance, health, and fertility

Princeton, NJ, USA: Princeton University (doctoral dissertation) Princeton University, Princeton, NJ, USA This thesis is a collection of essays in the economics of health insurance, […]

A simple but efficient approach to the analysis of multilevel data

Health Economics Papers 2013:6. Odense, Denmark: University of Southern Denmark. University of Southern Denmark, Odense, Denmark Much research in health economics revolves around the analysis […]

Adjusted clinical groups: a patient classification system through risk adjustment

Rev Peru Med Exp Salud Publica 30:308-314. Published in Spanish. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain Adjusted Clinical Groups (ACG) are risk […]

High-Risk Case Identification for Use in Comprehensive Complex Care Management

  High-Risk Case Identification for Use in Comprehensive Complex Care Management Because patients with multiple chronic conditions require proactive, coordinated care management to effectively manage […]

Population Health Management through Care Coordination and Interventions

Population health management at JHHC represents a comprehensive approach to health care considering the distribution of health outcomes within a population, and the health determinants […]

Casemix and Quality

Hospital Authority Casemix and Quality – Are they rivals or partners? Dr. K.H. Lee

Tuesday-Managing hospitalization risk-Terry and Oberg

Dovetail Managing Hospitalization Risk: Refining Patient Selection in a Care Transitions Program Lara Terry, MD. Jeff Oberg

Monday-US Health Reform-Abrams

Johns Hopkins ACG System Using ACGs to Support Risk Adjusted Premiums within the Health Insurance Exchange Chad Abrams

Monday-Advances in modeling risk-Thibodeau

Medica Leveraging the John Hopkins ACG Tool to Support Total Cost of Care Contracts Peter M. Thibodeau

Implementing the ACG risk within NHS

NHS Airedale, Bradford & Leeds Cluster Information Services Implementing the ACG risk of hospitalization model with NHS data: experiences from Leeds Dr Thomas Mason MA., […]

Using Predictive Modeling to Identify Readmission Risk

Johns Hopkins Bloomberg School of Public Health Using Predictive Modeling to Identify Readmission Risk K. Lemke

Monday(C3)-Geographically Identifying Expanded Diagnosis Clusters in the Hispanic/Latino Population —Thomas Ludden

Geographically Identifying Expanded Diagnosis Clusters in the Hispanic/Latino Population  —Thomas Ludden, Carolinas Healthcare System  

Wednesday(C9)-Swinging from a new tee – towards ‘The Extended Epidemiology’ by analysing the outcome from ACG processing in a County Council in Sweden

Swinging from a new tee – towards ‘The Extended Epidemiology’ by analysing the outcome from ACG processing in a County Council in Sweden —Ulf Börjesson, […]

Care Density: Amy Salls, DST Health Solutions

ACG System DST Health Solutions Care Density Amy Salls

The ACG System as a Common Language

Chad Abrams, Director of U.S. Operations, ACG System; describes common challenges around the world such as language differences, data quality, turning data into impact, and […]

Segmentation Case Study

Slough Clinical Commissioning Group (CCG), which covers a population of 143,000 in the UK, used the Johns Hopkins ACG System to conduct a population health analysis that generated several new insights. After just 18 months, unplanned hospitalizations were reduced by 18% and emergency department visits were reduced by 19%.

Post-acute pathways among hip fracture patients: a system-level analysis

Background: Hip fractures among older adults are one of the leading causes of hospitalization and result in significant morbidity, mortality, and health care use. Guidelines […]

Examination of Health System Resources and Costs Associated With Transitioning Cancer Survivors to Primary Care: A Propensity-Score–Matched Cohort Study

Background: Transitioning low-risk cancer survivors back to their primary care provider (PCP) has been shown to be safe but the effect on health system resources […]

Using EMRALD to assess baseline body mass index among children living within and outside communities participating in the Ontario, Canada Healthy Kids Community Challenge

Abstract   Objectives The Healthy Kids Community Challenge is a large-scale, centrally-coordinated, community-based intervention in Ontario, Canada that promotes healthy behaviours towards improving healthy weights […]

The Association Between Continuity of Primary Care and Preventive Cancer Screening in Women With Intellectual Disability

Abstract Women with intellectual disability have low screening rates for breast and cervical cancer. This population-based cohort study examined the association between the level of […]

The Lifestyle Medicine Physician’s Case to Self-Insured Employers: A Business Model for Physicians, a Bargain for Companies

Abstract   A majority of Americans have health care insurance through their employers, the cost for which is rising at an alarming rate. Unfortunately, higher […]

Predicting Short-Term Outcomes After Radical Cystectomy Based on Frailty

Abstract Objective To evaluate the impact of frailty on adverse perioperative outcomes in patients treated with radical cystectomy for bladder cancer. Material and Methods We […]

Production of physician services under fee‐for‐service and blended fee‐for‐service: Evidence from Ontario, Canada

Abstract We examine family physicians’ responses to financial incentives for medical services in Ontario, Canada. We use administrative data covering 2003–2008, a period during which […]

Patient frailty predicts worse perioperative outcomes and higher cost after radical cystectomy

Abstract Background Relatively few studies investigated the importance of frailty in radical cystectomy (RC) patients. We tested the ability of frailty, using the Johns Hopkins […]

Patient-reported symptoms following diagnosis in esophagus cancer patients treated with palliative intent

Summary The majority of patients with esophagus cancer have advanced-stage disease without curative options. For these patients, treatment is focused on improving symptoms and quality […]

Peri‐complication diagnosis of hepatitis C infection: Risk factors and trends over time

Abstract Background & Aims Hepatitis C virus (HCV) is a common and treatable cause of cirrhosis and its complications, yet many chronically infected individuals remain […]

Using Health Plan Authorization Data to Predict Hospitalizations and Readmissions in a Combined Commercial and Medicaid Population

Abstract Health plans develop predictive models to predict key clinical events (eg, admissions, readmissions, emergency department visits). The authors developed predictive models of admissions and […]

Association between socioeconomic deprivation and surgical complications in adults undergoing ankle fracture fixation: a population-based analysis

Abstract Background Few studies have investigated the outcomes of surgical fracture care among socially deprived patients despite the increased incidence of fractures and the inequality […]

Breast cancer diagnosis and treatment wait times in specialized diagnostic units compared with usual care: a population-based study

Abstract Background Breast assessment sites (bass) were developed to provide expedited and coordinated care for patients being evaluated for breast cancer (bca) in Ontario. We […]

Epidemiology and Impact of Spinal Cord Injury in the Elderly: Results of a Fifteen-Year Population-Based Cohort Study

Abstract Objective Although experience suggests a shift in the epidemiology of spinal cord injury (SCI) toward an older demographic, population studies are lacking. We aimed […]

Systematic review on the instruments used for measuring the association of the level of multimorbidity and clinically important outcomes

ABSTRACT Objectives There are multiple instruments for measuring multimorbidity. The main objective of this systematic review was to provide a list of instruments that are […]

Inequities in access to primary care among opioid recipients in Ontario, Canada: A population-based cohort study

Abstract Background Stigma and high-care needs can present barriers to the provision of high-quality primary care for people with opioid use disorder (OUD) and those […]

Prevalence, determinants, and outcomes of SARS-COV-2 infection among cancer patients. A population-based study in northern Italy

Abstract Background It is well established that cancer patients infected with SARSCoV-2 are at particularly elevated risk of adverse outcomes, but the comparison of SARS-CoV-2 […]

Outcomes after the regionalization of care for high-grade endometrial cancers: a population-based study

Abstract Background In June 2013, Ontario Health (Cancer Care Ontario), the agency responsible for advancing cancer care in Ontario, Canada, published practice guidelines recommending that […]

Pre-operative wait times in high-grade non-endometrioid endometrial cancer: Do surgical delays impact patient survival?

Abstract Objective Practice guidelines advocating for regionalization of endometrial cancer surgery to gynecologic oncologists practicing in designated gynecologic oncology centres were published in Ontario in […]

Patterns Of Multimorbidity Of Patients In Geriatric Care – A Register-Based Cohort Study In Sweden

Abstract Background Patients in geriatric care display a high degree of multimorbidity. We aimed to explore and visualise various patterns of multimorbidity in a person-oriented […]

Impact of Social Needs in Electronic Health Records and Claims on Health Care Utilization and Costs Risk-Adjustment Models Within Medicaid Population

Abstract Patients enrolled in Medicaid have significantly higher social needs (SNs) than others. Using claims and electronic health records (EHRs) data, managed care organizations (MCOs) […]

Creating a Cost-map From Claims Data to Guide Improvement Actions for Children With Asthma

Abstract Purpose It is difficult to reduce cost and improve quality without knowledge pertaining to the distribution of expenses in the population in question. We […]

Risk Stratification with only EHR Data – White Paper

Risk stratification models have traditionally used medical and pharmacy claims data combined with other sources, such as electronic health records (EHRs).  But provider organizations often […]

Reducing Emergency Department Use

People usually go to the Emergency Department (ED) when they are experiencing a medical emergency. But some people choose the ED for non-urgent care, which […]

Case Mix Measurement

This webinar provides an introduction to the principle of case mix and the constructs within the ACG System that make this possible. This session is a […]

Applications of the ACG System in the UK

This white paper provides an overview of the ACG System and how it is being used to support a range of clinical and commissioning activities […]

Physician referral rates: style without much substance?

Med Care 38:836-846. Department of Family Medicine, University of Rochester, New York, NY, USA BACKGROUND: Primary care physicians (PCPs) exhibit widely varying referral rates, resulting […]

Constructing ”behavioral” comparison groups: a difference-in-difference analysis of the effect of copayment based on the patient’s price elasticity

Eval Health Prof 37:434-456. National Kaohsiung First University of Science and Technology, Kaohsiung, Taiwan It is well known that the differences-in-differences (DD) estimator is based […]

Revisiting the economic efficiencies of observation units

Manag Care 24:46-52. University of Texas, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center HSR&D, Houston, TX, USA; Baylor College of Medicine, Houston, […]

Profiling resource use: do different outcomes affect assessments of provider efficiency?

Am J Manag Care 8:1105-1115. Center for Health Quality, Outcomes and Economic Research, Bedford Veterans Affairs Medical Center, Bedford, MA, USA OBJECTIVES: To examine whether […]

The case for case-mix adjustment in practice profiling. When good apples look bad

JAMA 272:871-874. Harvard Community Health Plan, Brookline, MA, USA OBJECTIVE: To assess the influence of patient characteristics on practice profiling. Using the example of specialty […]

The patient-centered medical home and associations with health care quality and utilization: a 5-year cohort study

Ann Intern Med 164:395-405. Weill Cornell Medical College, New York, NY, USA BACKGROUND: Effects of the patient-centered medical home (PCMH) are unclear. Previous studies had […]

Association between electronic health records and health care utilization

Appl Clin Inform 6:42-55. Weill Cornell Medical College, New York, NY, USA BACKGROUND: The federal government is investing approximately $20 billion in electronic health records […]

Indication for pharmacological treatment is often lacking: a cross-sectional study on the quality of drug therapy among the elderly

BMC Geriatr 15:117. Lund University, Malmö, Sweden; Stanford University School of Medicine, Stanford, CA, USA; University of Southern Denmark, Odense C, Denmark BACKGROUND: Although the […]

Infliximab in ulcerative colitis: the impact of preoperative treatment on rates of colectomy and prescribing practices in the province of British Columbia, Canada

Dis Colon Rectum 57:83-90. University of British Columbia, Vancouver, BC, Canada BACKGROUND: Approximately 20% of patients with ulcerative colitis will require surgical treatment. Recent data […]

Effect of practice variation on resource utilization in infants hospitalized for viral lower respiratory illness.

Pediatrics 108:851-855. University of Virginia Children’s Medical Center, Charlottesville, Virginia, USA OBJECTIVE: Hospital care for children with viral lower respiratory illness (VLRI) is highly variable, […]

Benefits and pitfalls in applying the experience of prepaid group practices to the U.S. physician supply

Health Aff W4:73-75. Center for Health Workforce Studies, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA The paper […]

Does a diagnosis of schizophrenia reduce rates of mammography screening? A Manitoba population-based study

Schizophr Res 113:95-100. Department of Psychiatry, University of Manitoba, CancerCare Manitoba, Winnipeg, MB, Canada It is estimated that mammography screening can reduce mortality from breast […]

Using multiple data features improved the validity of osteoporosis case ascertainment from administrative databases.

J Clin Epidemiol 61:1250-1260. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada OBJECTIVES: The aim was to construct and validate algorithms for […]

Risk adjustment in health insurance exchanges for individuals with mental illness

Am J Psychiatry 169:704-709. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA OBJECTIVE: In 2014, an estimated […]

Prevalence of health problems and primary care physicians’ specialty referral decisions

J Fam Pract 50:427-432. Health Services Research and Development Center, Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, […]

Early dropout from psychotherapy for depression with group- and network-model therapists

Adm Policy Ment Health 39:440-447. Group Health Research Institute, Seattle, WA, USA Administrative data were used to examine early dropout among 16,451 health plan members […]

Using the Johns Hopkins Aggregated Diagnosis Groups (ADGs) to predict mortality in a population-based cohort of adults with schizophrenia in Ontario, Canada

Psychiatry Res 196:32-37. Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, ON, Canad Administrative health care databases are increasingly used for health services and […]

Multimorbidity patterns in primary care: interactions among chronic diseases using factor analysis

PLoS One 7:e32190. IIS Aragón, Aragón Health Sciences Institute, Miguel Servet University Hospital, University of Zaragoza, Zaragoza, Spain OBJECTIVES: The primary objective of this study […]

The effect of capitation on switching primary care physicians

Health Serv Res 38:191-209. University of Rochester School of Medicine and Dentistry, Department of Community and Preventive Medicine, Rochester, NY, USA OBJECTIVE: To examine the […]

How well do Ambulatory Care Groups predict expenditures on mental health and substance abuse patients?

Adm Policy Ment Health 24:339-357. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA This paper evaluates the ability of Ambulatory Care Groups […]

Stratification of the population in the Basque Country: results in the first year of implementation

Aten Primaria 45:54-60. Published in Spanish. Instituto Vasco de Innovación Sanitaria, Sondika, Bizkaia, Spain Predictive models allow populations to be stratified according to their health […]

Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network

BMC Health Serv Res 12:153. Department of Health Care Management and Policy, University of Surrey, Guildford, UK BACKGROUND: Internationally health services are facing increasing demands […]

Comorbidity-based payment methodology for Medicaid enrollees with HIV/AIDS

Health Care Financ Rev 23:53-68. Center for Health Program Development and Management, University of Maryland Baltimore County, Baltimore, MD, USA Managed care organizations (MCOs) may […]

Monitoring the prevalence of chronic conditions: which data should we use?

BMC Health Serv Res 12:365. Osakidetza, Basque Health Service, C/ Alava n° 45, Vitoria-Gazteiz, Spain BACKGROUND: Chronic diseases are an increasing threat to people’s health […]

Effect of patient socioeconomic status on physician profiles for prevention, disease management, and diagnostic testing costs

Med Care 40:717-724. Department of Family and Community Medicine, University of California School of Medicine, Davis, CA, USA BACKGROUND: Previous research shows patient socioeconomic status […]

Medical and pharmacy expenditures after implementation of a cyclooxygenase-2 inhibitor prior authorization program

Pharmacotherapy 25:924-934. Medical and Pharmacy Integration Services, Prime Therapeutics, LLC, Eagan, MN, USA STUDY OBJECTIVE: To evaluate the effects of a cyclooxygenase (COX)-2 inhibitor prior […]

The MMPI-2: a contemporary normative study of midwestern family medicine outpatients

J Clin Psychol Med Settings 15:98-119. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA For more than 60 years it has been known […]

Relationships between physical activity and perceived qualities of life in old age

Results of the SNAC study. Aging Ment Health 13:1-8. School of Social Science, Vaxjo University, Vaxjo, Sweden OBJECTIVES: The aim of the present study was […]

Impact of morbidity, resource use and costs on maintenance of remission of major depression in Spain: a longitudinal study in a population setting

Gac Sanit 24:13-19. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials S.A., Badalona, Barcelona, Spain OBJECTIVE: To determinate the impact of comorbidity, resource use […]

A population-based study of the association between socioeconomic status and emergency department utilization in Ontario, Canada

Acad Emerg Med 18:836-843. Division of Emergency Medicine, Department of Medicine, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada OBJECTIVES: The […]

Complementary and alternative medicine provider use and expenditures by cancer treatment phase

Am J Manag Care 14:326-334. Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA OBJECTIVE: To assess […]

A comparison of health care use for physician-referred and self-referred episodes of outpatient physical therapy

Health Serv Res 47:633-654. Center for Public Health Statistics, University of Iowa, Iowa City, IA, USA OBJECTIVE: To compare patient profiles and health care use […]

A population-based description of atrial fibrillation in the emergency department, 2002 to 2010

Ann Emerg Med 62:570-577. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada; […]

Preeclampsia as a risk factor for diabetes: a population-based cohort study

PLoS Med 10:e1001425. Department of Medicine, University of Toronto, Toronto, ON, Canada BACKGROUND: Women with preeclampsia (PEC) and gestational hypertension (GH) exhibit insulin resistance during […]

Vaccine effectiveness against laboratory-confirmed influenza hospitalizations among elderly adults during the 2010-2011 season

Clin Infect Dis 57:820-827. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada BACKGROUND: Although annual influenza immunization is recommended for adults aged ≥65 years due […]

Morbidity and costs associated to neurological disorders

Neurologia 28:126-129. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain La presencia de múltiples enfermedades es frecuente en edades avanzadas, y diferentes estudios poblacionales […]

Pneumococcal vaccine targeting strategy for older adults: Customized risk profiling

Vaccine 32:990-995. Clalit Research Institute, Tel Aviv, Israel BACKGROUND: Current pneumococcal vaccine campaigns take a broad, primarily age-based approach to immunization targeting, overlooking many clinical […]

Prevalence and costs of multimorbidity by deprivation levels in the Basque country: a population based study using health administrative databases

PLoS One 9:e89787. Basque Health Service, Erandio, Bizkaia, Spain; Basque Institute for Healthcare Innovation, Sondika, Bizkaia, Spain; Universidad Complutense de Madrid, Madrid, Spain; Australian National […]

The impact of morbidity trajectories on identifying high-cost cases: using Taiwan’s National Health Insurance as an example

J Public Health 36:300-307. Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. BACKGROUND: Incorporating longitudinal information […]

Exploring the Johns Hopkins Aggregated Diagnosis Groups in administrative data as a measure of child health

This study explored the utility of the Johns Hopkins Aggregated Diagnostic Groups (ADGs) as a noncategorical measure of child health in administrative health data. Canadian […]

The hassle of wellness: do peers and health status matter?

In: Population Association of America, eds. 2014 Annual Meeting, Population Association of America. Princeton, NJ, USA: Population Association of America. Cornell University, Ithaca, NY, USA […]

A data-driven approach towards patient identification for telehealth programs

2015 IEEE International Conference on Big Data :2551-2559. Robert Bosch (US), Palo Alto, CA, USA Telehealth provides an opportunity to reduce healthcare costs through remote […]

An actuarial perspective on healthcare expenditure in the last year of life

Washington, DC: International Congress of Actuaries. University of Cape Town, South Africa The aim of this paper is to highlight the key methodological considerations in […]

A hierarchical multivariate two-part model for profiling providers’ effects on health care changes

J Am Statistical Assoc 101:911-923. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Procedures for analyzing and comparing health care providers’ effects on […]

Risk adjustment in state Medicaid programs

Health Watch :14-17, 32-34. Denver, Colorado, office of Wakely Consulting Group This article discusses some of the most important considerations in implementing risk adjustment within […]

Health-based risk adjustment: application to premium development and profiling

In: Wrightson CW, eds. Financial strategy for managed care organizations: rate setting, risk adjustment, and competitive advantage. Ann Arbor, MI, USA: Health Administration Press:165-225. Health […]

Evaluation of casemix adjustment methods for the Massachusetts Division of Medical Assistance

Massachusetts Rate Setting Commission. Final report and recommendation. Boston, MA, USA: Massachusetts Rate Setting Commission. Massachusetts Rate Setting Commission, Boston, MA, USA We investigated methods […]

How well do models work? Predicting health care costs

In: American Statistical Association, eds. Proceedings of the Section on Statistics in Epidemiology. Alexandria, VA, USA: American Statistical Association:42-49. Department of General Internal Medicine, Boston […]

A risk stratification model for adult patients with obstructive sleep apnea: development and evaluation

Toronto, ON, Canada: Institute for Clinical Evaluative Sciences. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada STUDY HYPOTHESES: We hypothesize that the apnea-hypopneas index (AHI), […]

Studying effects of primary care physicians and patients on the trade-off between charges for primary care and specialty care using a hierarchical multivariate two-part model

Department of Biostatistics Working Paper 51. Baltimore, MD, USA: Johns Hopkins University. Johns Hopkins University, Baltimore, MD, USA OBJECTIVE. To examine effects of primary care […]

An incentive mechanism for using risk adjuster to reimburse health care provider

York, UK: University of York. University of York, York, UK Health care providers are almost always universally reimbursed by third party purchasers. As a result, […]

Prompt reduction in use of medications for comorbid conditions after bariatric surgery

Rockville, MD, USA: Agency for Healthcare Research and Quality. Johns Hopkins University, Baltimore, MD, USA BACKGROUND. Bariatric surgery leads to weight loss, but it is […]

The dynamic effects of medical risk costs: evidence from quantile regression

Journal of Statistics and Management Systems 14:843-868. This paper adopted the quantile regression (QR) estimator to assess the effects of the medical utilization factors (changes […]

An economic analysis of secure messaging between patients and providers

Seattle, WA, USA: University of Washington (doctoral dissertation). University of Washington, Seattle, WA, USA This dissertation presents an economic analysis of patient-provider communication through secure […]

Comorbilidad y discapacidad en pacientes con insuficiencia cardiaca

Madrid, Spain: Universidad Autonoma de Madrid (doctoral dissertation). Published in Spanish. Universidad Autonoma de Madrid, Madrid, Spain INTRODUCCIÓN: La insuficiencia cardiaca (IC) es un problema […]

Thiazolidinedione use and risk of hospitalization for pneumonia in type 2 diabetes:  population based matched case-control study

F1000Research 2:145. Department of Medicine, Johns Hopkins University Schools of Medicine and Public Health, Baltimore, MD, USA OBJECTIVE: Previous randomized clinical trials and their meta-analyses […]

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