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

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.

Arizona Roundtable