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Wisconsin Evaluation of Emergency Department Care Coordination

Completed
Conditions
Emergency Department Visit
Interventions
Other: Intensive Care Coordination
Registration Number
NCT04550169
Lead Sponsor
University of Wisconsin, Madison
Brief Summary

The State of Wisconsin is now expanding its investment in care coordination models as an effort to reduce inappropriate hospital emergency department (ED) use, improve health outcomes, and reduce Medicaid expenditures. This effort begins with a pilot program to support emergency department care coordination in hospitals and health systems that apply and are selected to participate in the pilot program.

The Wisconsin Medicaid program seeks to understand whether this program achieves its intended goals and, specifically, whether the Medicaid payment for such care coordination services produces the intended program outcomes. Hospitals will select members that will receive care coordination services. In a quasi-experimental approach, the study team will compare members that do vs. do not receive the services will be used examine the effects of care coordination and referrals on total ED visits, primary-care treatable ED visits, non-emergent ED visits, and health care costs, as well as the specific effects of referring patients to providers who offer low-cost and after-hours care. To assess the importance of targeting, study team will conduct stratified analyses of vulnerable groups such as people with disabilities and individuals with specific clinical needs.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
3405
Inclusion Criteria
  • Adults who are Medicaid enrolled
  • Have had 5+ emergency department visits in the past year
Exclusion Criteria
  • Participants who are concurrently eligible for Medicare
  • Children (individuals age <18 years).

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Intensive Care CoordinationIntensive Care CoordinationIntensive Care Coordination along with Standard of Care
Primary Outcome Measures
NameTimeMethod
Cost to Medicaid for all Emergency Department Visits24 months
Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions24 months
Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions24 months
Total Number of Emergency Department Visits24 months
Secondary Outcome Measures
NameTimeMethod
Number of Participants Who Used Specialty Care Visits6, 12, 18, and 24 months
Total Number of Primary Care Visits6, 12, 18, and 24 months
Number of Participants Who Used Any Primary Care Visits6, 12, 18, and 24 months
Number of Participants with Any Hospitalizations6, 12, 18, and 24 months
Total Number of Specialty Care Visits6, 12, 18, and 24 months
Number of Hospitalization Events6, 12, 18, and 24 months
Total costs of care to Medicaid6, 12, 18, and 24 months
Number of participants enrolled in FoodShare6, 12, 18, and 24 months

FoodShare is a program that helps people with limited resources buy the food they need for good health.

Number of visits to use alcohol and other drug abuse resources if applicable for the participant6, 12, 18, and 24 months
Number of visits to use behavioral health resources, if applicable for the participant6, 12, 18, and 24 months
Number of participants enrolled in Temporary Assistance for Needy Families (TANF)6, 12, 18, and 24 months
Total Cost Related to the Use of Behavioral Health Resources if applicable for the participant6, 12, 18, and 24 months
Total Cost Related to Use of Alcohol and other Drug Abuse Resources if applicable for the participant6, 12, 18, and 24 months

Trial Locations

Locations (4)

ThedaCare

🇺🇸

Appleton, Wisconsin, United States

Ascension Wisconsin

🇺🇸

Glendale, Wisconsin, United States

Aurora Health Care

🇺🇸

Milwaukee, Wisconsin, United States

Froedtert Health , Wisconsin

🇺🇸

Wauwatosa, Wisconsin, United States

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