Applying population-based case mix adjustment in managed care: the Johns Hopkins Ambulatory Care Group system.

N. S. Smith, J. P. Weiner

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)21-34
Number of pages14
JournalManaged care quarterly
Volume2
Issue number3
StatePublished - Jun 1 1994
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Applying population-based case mix adjustment in managed care: the Johns Hopkins Ambulatory Care Group system.'. Together they form a unique fingerprint.

Cite this