The ACG System can also be used for quality improvement, outcomes management and case management purposes.
Quality improvement and outcomes management often involve focusing on one or more specific diseases and comparing a process measure (e.g., appropriate use of lab tests, prescription of certain medications) or an outcomes measure (e.g., asthma inpatient admissions or emergency room visits) across several providers or health plans. In this context, ACGs control for differences in case-mix or severity of illnesses among the populations being compared.
While the use of the ACG System for quality improvement and outcomes management in the aforementioned context is a retrospective activity, the ACG System may also be used prospectively for quality improvement purposes to identify patients with special needs. Once identified, these patients, who typically suffer from multiple, chronic conditions, can then be case managed to better coordinate and ensure the quality of their care.