The Johns Hopkins Adjusted Clinical Groups® (ACG®) System offers a unique approach to measuring morbidity that improves accuracy and fairness in evaluating provider performance, identifying patients at high risk, forecasting healthcare utilization and setting equitable payment rates.
The ACG System measures the morbidity burden of patient populations based on disease patterns, age and gender. It relies on the diagnostic and/or pharmaceutical code information found in insurance claims or other electronic medical records. This provides the user with a more accurate representation of the morbidity burden of populations, subgroups or individual patients - as a constellation of morbidities, not as individual diseases.
What Distinguishes the ACG System from other Case Mix Systems?
Another distinguishing feature is the ACG System's ability to handle, describe and manage healthier populations (i.e., low users of health care services). Unlike other systems, ACGs were developed using commercial managed care populations as well as state Medicaid populations, both of which closely resemble the general population. Most other case-mix risk adjustment methods were developed using sicker, more specialized patient populations such as the Medicare, Medicaid, or disabled populations and have only later been adopted or modified to suit the needs of a more general patient population.
The ACG System has been used in commercial and research settings worldwide, longer and more extensively than any other system on the market today. It is a tried and true software product which has undergone numerous improvements and modifications in response to user needs.
The ACG System is a key component of the NQF certified TCOC methodology, designed to support affordability initiatives, to identify instances of overuse and inefficiency, and to highlight cost-saving opportunities.