Not all frail patients are high cost

Click to read the full case study.

The English National Health Service (NHS) is the publicly funded national healthcare system.

The services provided by the NHS are commissioned by regional Clinical Commissioning Groups (CCGs), which decide which services should be resourced in their local communities. The CCGs use the Johns Hopkins ACG® System output to help them understand their communities and connect patients to appropriate care.

Three CCGs analyzed their local populations as part of a new national initiative to address the care of people who are frail. The initiative to support the frail population stems from evidence that resource use increases with an increasing degree of frailty and that addressing frailty in a population would reduce costs and resource use. However, the CCGs posited that frailty is only one of the drivers of cost, in addition to other factors, including multi-morbidity.

The segmentation analysis, using the ACG System, showed that multi-morbidity, more than frailty, was the main driver of unplanned hospitalization and high costs.

This led the CCGs to focus their attention on the highest risk and highest cost groups: populations who are not frail, but multi-morbid, as well as those who are frail and multi-morbid, and require intensive support and proactive management.

Read the complete case study here.



Balance is a therapist-supported, digital behavioral health program that makes mental health care easier and more accessible.
The ACG System helps you combine a population-level perspective with patient-level behaviors and conditions, allowing you to be proactive rather than reactive when it comes to your population’s unique health care needs.
Blossom is an interactive guide that combines biometric tech, expert advice and support from loved ones to help you assess, understand and optimize your fight against diabetes.
Work Stride offers cancer prevention and education, as well as personalized nurse navigation at each stage of the cancer journey. Designed for employees, dependents, caregivers and managers.