Accountable Care Management System

CTG's Accountable Care Management System (ACMS) solution addresses a major challenge facing health insurers: balancing necessary care with costs while improving outcomes. Traditional care management looks primarily at claims data. ACMS takes a completely different and more analytical approach.

CTG developed the ACMS solution to evaluate care management and improveACMS Tipping Point
outcomes for patients with chronic kidney disease (CKD), one of the most serious and costly-to-treat illnesses. The solution's premise is that over time, blood chemistry is the best measure of how well CKD treatment is working and if claims dollars are being spent most effectively. The ACMS software analyzes clinical outcomes and claims data for similar CKD patients to identify treatment intervention points that will result in lower treatment costs and a better quality of life for CKD patients.

In addition to CKD, ACMS can provide a road map to better value-based outcomes for treating other serious illnesses. Congestive heart failure, asthma, and orthopedic fractures are next in the queue for expanding the scope of CTG's ACMS solution.

How ACMS Works
  • The software uses blood chemistry results over time to calculate a single ACMS score, which is indicative of the patient's overall medical condition.
  • ACMS scores provide a common measure to compare patients with similar illness complexities but different treatment outcomes.
  • This comparison leads to better value-based outcomes by following the treatment course of patients with lower ACMS scores.

ACMS is a win/win/win solution for payers, providers, and patients.

Payers
  • Identifies best provider networks
  • Reduces treatment costs for serious illnesses with potential savings of approximately 10 percent
  • Provides care quality measurement that is not solely based on claims dollars
  • Determines reimbursement models based on patient complexity and outcomes.
Providers
  • Identifies best practices that lead to optimal outcomes
  • Identify therapies that yield fewer events and reduce length of stay
  • Guides optimal timing for referral to specialists
Patients
  • Identifies preferred treatment course for better outcomes
  • Guides optimal timing for referral to specialists
  • Provides patients targeted health coaching assistance