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The distinguishing feature of the ACG Case-Mix System is its "person-focused" approach which
allows it to capture the multidimensional nature of an individual's health
over time.
Unlike other systems, the AGC System:
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Categorizes a person's entire grouping of morbidities, rather
than procedures (e.g., a total hip replacement
operation), discrete episodes of care (e.g., all of
the inpatient and outpatient visits or treatments associated
with lymphoma, a type of cancer) or distinct clinical
conditions (e.g., hypertension, diabetes, etc.).
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Views a person as more
than simply the sum of his/her "body-part" ICD-9
diagnosis codes. ACGs follow a holistic approach, grouping
people based on their entire constellation of diagnoses
across all types of reimbursable providers and settings
over a period of time.
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Is a patient-oriented
methodology that mirrors most health care organizations'
shift in recent years from a " disease care" approach
to a more patient-oriented, population-based health
care approach to providing medical care.
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Developed by an academic institution.
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 Case-Mix System has been used in commercial and
research settings longer and more extensively than most other
systems on the market today. It is a tried and true software
product which has undergone numerous improvements and modifications
in response to user needs.
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