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Am J Manag Care ; 24(11): e365-e370, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30452205

RESUMO

OBJECTIVES: Medicare, Medicaid, and commercial plans have all explored ways to improve outcomes for patients with high costs and complex medical and social needs. The purpose of this study was to test the effectiveness of a high-intensity care management program that the Rutgers University Center for State Health Policy (CSHP) implemented as an adaptation of a promising model developed by the Camden Coalition of Healthcare Providers. STUDY DESIGN: We estimated the impact of the program on 6 utilization and spending outcomes for a subgroup of beneficiaries enrolled in Medicare fee-for-service (n = 149) and a matched comparison group (n = 1130). METHODS: We used Medicare claims for all analyses. We used propensity score matching to construct a comparison group of beneficiaries with baseline characteristics similar to those of program participants. We employed regression models to test the relationship between program enrollment and outcomes over a 12-month period while controlling for baseline characteristics. RESULTS: A test of joint significance across all outcomes showed that the CSHP program reduced service use and spending in aggregate (P = .012), although estimates for most of the individual measures were not statistically significant. Participants had 37% fewer unplanned readmissions (P = .086) than did comparison beneficiaries. Although we did not find statistically significant results for the other 5 outcomes, the CIs for these outcomes spanned substantively large effects. CONCLUSIONS: Although these findings are mixed, they suggest that adaptations of the Camden model hold promise for reducing short-term service use and spending for Medicare super-utilizers.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Múltiplas Afecções Crônicas/terapia , Administração dos Cuidados ao Paciente/organização & administração , Serviços de Saúde Comunitária/economia , Planos de Pagamento por Serviço Prestado/estatística & dados numéricos , Feminino , Gastos em Saúde , Recursos em Saúde/estatística & dados numéricos , Humanos , Masculino , Medicare/estatística & dados numéricos , Múltiplas Afecções Crônicas/economia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Administração dos Cuidados ao Paciente/economia , Readmissão do Paciente/estatística & dados numéricos , Pontuação de Propensão , Estados Unidos
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