Impact on Health Care Utilization and Costs of a Medicaid Community Health Worker Program in Detroit, 2018-2020: A Randomized Program Evaluation.
Am J Public Health
; 112(5): 766-775, 2022 05.
Article
em En
| MEDLINE
| ID: mdl-35324259
ABSTRACT
Objectives. To compare health care utilization and costs between beneficiaries randomly assigned to usual services versus a community health worker (CHW) program implemented by 3 Medicaid health plans. Methods. From February 2018 to June 2019, beneficiaries residing in Detroit, Michigan's Cody Rouge neighborhood with more than 3 emergency department (ED) visits or at least 1 ambulatory careâsensitive hospitalization in the previous 12 months were randomized. CHWs reached out to eligible beneficiaries to assess their needs and link them to services. We compared ED and ambulatory care visits, hospitalizations, and related costs over 12 months. Results. In intention-to-treat analyses among 2457 beneficiaries, the 1389 randomized to the CHW program had lower adjusted ratios of ED visits (adjusted rate ratio [ARR] = 0.96; P < .01) and ED visit costs (ARR = 0.96; P < .01), but higher adjusted ratios of ambulatory care costs (ARR = 1.15; P < .01) and no differences in inpatient or total costs compared with the usual-care group. Conclusions. Initial increases in ambulatory care use from effective programs for underserved communities may mitigate savings from decreased acute care use. Longer-term outcomes should be followed to assess potential cost savings from improved health. Trial Registration ClinicalTrials.gov identifier NCT03924713. (Am J Public Health. 2022;112(5)766-775. https//doi.org/10.2105/AJPH.2021.306700).
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Medicaid
/
Agentes Comunitários de Saúde
Tipo de estudo:
Clinical_trials
/
Evaluation_studies
/
Health_economic_evaluation
/
Prognostic_studies
Aspecto:
Implementation_research
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Public Health
Ano de publicação:
2022
Tipo de documento:
Article