TY - JOUR
T1 - Applying population-based case mix adjustment in managed care
T2 - the Johns Hopkins Ambulatory Care Group system.
AU - Smith, N. S.
AU - Weiner, J. P.
PY - 1994/6/1
Y1 - 1994/6/1
N2 - When analyzing medical utilization or other health care-related measurements across provider panels, case mix adjustment is required because "illness burden" is often unevenly distributed across these patient populations. This article develops the rationale for case mix adjustment and walks readers through the case mix adjustment process using the Johns Hopkins Ambulatory Care Group (ACG) Case-Mix System as a model. The ACG system is a population-oriented patient classification tool based on diagnoses assigned by providers and found in payors' data systems. The system categorizes patients according to illness burden. It does not categorize visits, encounters, or episodes. ACGs adjust for case mix differences in the analysis of ambulatory, laboratory, pharmacy, and total health care service delivery.
AB - When analyzing medical utilization or other health care-related measurements across provider panels, case mix adjustment is required because "illness burden" is often unevenly distributed across these patient populations. This article develops the rationale for case mix adjustment and walks readers through the case mix adjustment process using the Johns Hopkins Ambulatory Care Group (ACG) Case-Mix System as a model. The ACG system is a population-oriented patient classification tool based on diagnoses assigned by providers and found in payors' data systems. The system categorizes patients according to illness burden. It does not categorize visits, encounters, or episodes. ACGs adjust for case mix differences in the analysis of ambulatory, laboratory, pharmacy, and total health care service delivery.
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M3 - Article
C2 - 10136807
AN - SCOPUS:0028451015
SN - 1064-5454
VL - 2
SP - 21
EP - 34
JO - Managed care quarterly
JF - Managed care quarterly
IS - 3
ER -