DST Health Solutions, LLC (Birmingham, Ala.) has released Version 9.0 of The Johns Hopkins University's Adjusted Clinical Groups (ACG) System. ACG Version 9.0 includes what the vendor characterizes as extensive enhancements that not only improve predictive accuracy but also identify opportunities for intervention to improve health outcomes. DST Health Solutions is the exclusive distributor of the ACG System in the United States.
"Risk adjustment and predictive modeling are critical to measuring population health to support quality assessment and payment reform," comments Professor Jonathan Weiner, co-developer of the original ACG System and leader of the research and development team at the Johns Hopkins Bloomberg School of Public Health. "The ACG System was conceived to ensure access and equity in healthcare purchasing. Version 9.0 will allow users to better understand the needs of the chronically ill."
According to a vendor press release, ACG Version 9.0 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, DST claims.
"Most predictive models focus heavily on costs, but often we already know about the highest cost members and there is little opportunity for intervention," remarks Don Hughes, president of Encompass Medical Management (West Des Moines, Iowa), an ACG client. "With the ACG System, we can describe populations for intervention where we can have the greatest impact through better coordination of care and targeted improvements in pharmacy adherence. The ACG System enables us to focus interventions for both the extreme high cost patients and those in danger of becoming high cost."
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 DST release alleges. The Johns Hopkins system applies unique clinical criteria--including information regarding medication use and coordination of care--to create intuitive ACG models for clients seeking greater insights into opportunities for early intervention, according to DST.
Anthony O'Donnell has covered technology in the insurance industry since 2000, when he joined the editorial staff of Insurance & Technology. As an editor and reporter for I&T and the InformationWeek Financial Services of TechWeb he has written on all areas of information ... View Full Bio