MedPath

IT to Support Integration of Social Determinant of Health Services to Reduce Avoidable Emergency Department Visits

Not Applicable
Conditions
Substance Use Disorders
Mental Health Issue
Interventions
Behavioral: Peer Integrated Care Services
Registration Number
NCT04125433
Lead Sponsor
Northern New York Rural Behavioral Health Institute
Brief Summary

Working through regional Accountable Care Organizations (ACO) the sponsor will establish a 2-year pilot project to demonstrate that early recognition and intervention in the various Social Determinant of Health (SDoH) domains can reduce avoidable Emergency Department (ED) visits by high utilizers. The regional ACO's will contract with Medicaid Managed Care Plans to assign traditional high ED utilizing members to the pilot project. Members will be offered enhanced peer facilitated care management services connecting members with available SDoH community based services. Members fitting our eligibility criteria will self-select by way of completing a pilot project consent form.

Detailed Description

The project employs a two level intervention to include Peer Support Specialist (PSS) and Community Health Advocate (CHA). Contact and engagement with participating members will be through both direct intervention in the emergency department by Peer Support Specialist (the peer) as well as in the community for prevention visits and follow up by both the peer and Community Health Advocate. These well-positioned Peers and Community Health Advocates will address Behavioral and Social Determinants of Health (SDoH) concerns through a highly coordinated intervention supported by a common IT Medicaid member tracking platform. This research project will determine the feasibility of deploying a single shared IT platform that will include referral, appointment completion, and intervention outcome data. Project staff will develop a trusting relationship with the members and will improve member access and engagement with community-based services. The project will also seek to determine the impact on total cost of care through redirecting study participants to community resources that are more appropriate, and less expensive than return visits to the emergency department.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
400
Inclusion Criteria
  • Adults age 18 to 65
  • New York State Medicaid Managed Care Members
  • Have utilized emergency department services 6 or more times in a 12-month period
  • Have been assigned to the Pilot Project by their Medicaid Managed Care Plan
Exclusion Criteria
  • Individuals not assigned by a Managed Care Organization meeting the above criteria

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Medicaid Emergency Department High UtilizersPeer Integrated Care ServicesThis Arm will include the following individuals * Up to 400 Adults age 18 to 65 * New York State Medicaid Managed Care Members * Have utilized emergency department services 6 or more times in a 12-month period * Have been assigned to the Pilot Project by their Medicaid Managed Care Plan
Primary Outcome Measures
NameTimeMethod
Change in Adoption and Use of IT PlatformMonths 6, 12, 18, 24

Change in Number of Participating Agencies That Contribute Data to the IT System

Change in Total Cost of Care for Participating MembersMonth 0, Month 24

Change in cost trend for participating members. Pre-study vs. study period.

Change in Engagement of Medicaid Member Participants with Peer Integration Care ServicesMonths 0, 3, 6, 9, 12, 15, 18, 21, 24

The change in acceptance by Medicaid Members of Peer Integrated Care Services

Secondary Outcome Measures
NameTimeMethod
Change in Emergency Room Visits by Participating MembersMonth 0, 6, 12,18,24

Change in rate of Emergency Department utilization by participating members.

Trial Locations

Locations (1)

Northern New York Rural Behavioral Health Institute

🇺🇸

Saranac Lake, New York, United States

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