A number of enhancements have been made to the ACG® System to improve statistical performance, and identify opportunities for intervention to improve health outcomes. ACG System Version 9.0i builds on the success of previous releases by identifying members with chronic conditions that are at risk for low adherence to prescription regimens, poor coordination of care among primary care providers and specialists, or acute hospitalization needs. Greater predictive accuracy is also achieved through further refinement of the ACG System’s clinical classifications.
Major new components include:
- Identification of gaps in medication adherence for chronic conditions where continuous medication use is warranted. Included adherence measures such as medication possession and continuous medication availability provide context for clinical screening applications.
- Measure for coordination of care focusing on the presence of a provider delivering the majority source of care, the number of individual providers and specialties involved, and the inclusion of a generalist in coordinating care. Coordination of care information is essential to assess the healthcare delivery process, quality of care, and provider performance assessment.
- Predictions of the likelihood of several types of acute inpatient events. The ACG System’s predictive hospitalization models can be used to prioritize high opportunity patients in need of care management.
- Predictions of the likelihood of unusually large pharmacy expenditures among individuals with moderate or high morbidity.
Health plans and physicians are finding that predictive models based solely upon statistical performance are not producing actionable information regarding member or patient care. The updated Johns Hopkins’ ACG System applies unique clinical criteria to create intuitive models for clients seeking greater insights into opportunities for early intervention.
