The ACT IndexSM

A national evaluation of advanced illness care

Why an Index?

The ACT IndexSM provides a readily understood, yet comprehensive, assessment of the effectiveness of efforts by policy makers, regulators, healthcare providers and communities to improve the quality of life for the advanced illness population and their families. This tool allows us to focus efforts and resources on initiatives that will be most effective for improving serious illness and end-of-life care for the advanced illness population.

What is in the Index?

The measures included in the Index address five key domains that must be addressed for those with advanced illness; these include care, caregiving, communication, community, and cost. Two measure types are incorporated into the Index: (1) patient and family surveys of the patient care experience and (2) transactional care processes such as cost, hospital readmissions, and home health visits. The 2017 ACT IndexSM depicts only national performance, but C-TAC is developing state-level indices in preparation for the 2018 National Summit on Advanced Illness Care in Denver, Colorado.

Value of an Index

Hundreds of measures have been used to describe aspects of advanced illness care; some show improvement, others do not. They vary in their scope, reporting frequency, sample size and other factors, making interpretation di cult, if not outright infeasible. The Index is designed to provide a single composite measure that illustrates overall performance of the advanced illness care movement, as reflected in the 25 metrics selected by national content experts.

The 2017 IndexSM

The Index introduced at the 2017 National Summit on Advanced Illness Care (November 2017) grew 20% between 2003-2014 – a compound annual growth rate of 1.7%.

Conclusion and Interpretation

Advanced illness care has improved consistently over the eleven-year period covered by the Index, but major challenges remain. Specifically, the doubling of the Medicare population poses significant concerns in areas such as workforce, facilities, and cost. Continued use of a composite index of performance will provide the public, providers, and policy-makers with the data that can inform evidence-based decision making and track progress over time.

- A Deeper Look -

The measures included in the Index reflect five domains for person-centered care:

  1. Higher quality, timely care
  2. Greater caregiver support
  3. Strengthen community support
  4. Ensure cost-effective care in aligned with individual goals and values
  5. Ensure compassionate, coordinated communications