Daniel M. Brown, Ph.D., from Contra Costa Health Services in Martinez, California, and colleagues assessed the population-level impact of a 12-month case management program designed to address patients’ social needs. Analysis included 57,972 randomized enrollments of adult Medicaid patients at elevated risk for health care use (top 15 percent).
The researchers found that participants in the intervention group tended to visit the emergency department less for all visits (rate ratio, 0.96; 95 percent confidence interval, 0.91 to 1.00) and for avoidable visits (rate ratio, 0.97; 95 percent confidence interval, 0.92 to 1.03) versus the control group. Hospitalization rates were also lower for the intervention group for all admissions (rate ratio, 0.89; 95 percent confidence interval, 0.81 to 0.98) and for avoidable admissions (rate ratio, 0.72; 95 percent confidence interval, 0.55 to 0.88).
“Although social needs case management programs may reduce health care use, these savings may not cover full program costs,” the authors write. “More work is needed to identify ways to increase patient uptake and define characteristics of successful programs.”
Contra Costa Health Services funded the study via the Medicaid waiver program.