The Advanced Care Transformation (ACT) IndexSM

A state-by-state evaluation of advanced illness care

What is the Index?

The ACT IndexSM allows policymakers, regulators, healthcare providers, communities, and consumers to assess the overall performance of the serious illness care movement through measured change over time. While the index initially captured performance at the national level, C-TAC adapted the composite for state-level use in 2018 to allow for state-to-state comparisons and highlight opportunities for improvement.

Index Goals

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.

How are measures chosen?

Each of the ACT IndexSM measures was carefully selected by C-TAC, invited stakeholders, and serious illness experts to capture key facets of serious illness care. Selected ACT Index measures are reviewed and approved by an independent steering committee. Some measures are fully specified and in use in accountability programs for various entities, while others are measures of population health that have not been tested and validated for use in payment or other accountability programs for specific populations.

New ACT Achievement Index Rankings - Dec 2019

- 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

New Report Highlights Best Practices in Advance Care Planning

Evidence-Based Best Practices for Improving State-Level C-TAC ACTSM Index Results

C-TAC has released the full version of a report designed to identify strategies that could be used to boost the use of advance care planning (ACP), a practice that is now more important than ever as we face the uncertainties of the COVID-19 pandemic. Discern Health, a healthcare quality and research advisory organization, developed the report. This research will help to further enhance C-TAC’s Advanced Care Transformation (ACT) IndexSM. This project focuses on one of the 37 ACT Index measures, Medicare fee-for-service beneficiaries with advance care planning. The measure captures the percent of Medicare fee-for-service beneficiaries with an ACP-specific billing code recorded on a claim.

Regional Index Coaches

C-TAC has recruited Regional Index Coaches in Hawaii, the highest performer on the Index’s ACP measure, as well as in Louisiana, which showed lower rates of ACP but evidence of progress. These coaches will identify opportunities to increase the use of ACP on the local level and share their expertise with collaborators on the ground. Click on the dropdown menus below to learn more about our Regional Index Coaches.

Examples from the Field: Arizona

C-TAC is collaborating with organizations on the ground in Arizona, with support from the David
and Lura Lovell Foundation on a three-year project to analyze the quality of serious illness care in the state, using the ACT Index. This will lead to the creation of a best practices library which can drive improvements and innovation in care.