Match!

A Novel Intervention for High-Need, High-Cost Medicaid Patients: a Study of ECHO Care.

Published on Jan 1, 2020in Journal of General Internal Medicine4.606
· DOI :10.1007/S11606-019-05206-0
Miriam Komaromy1
Estimated H-index: 1
(BMC: Boston Medical Center),
Miriam Komaromy15
Estimated H-index: 15
+ 10 AuthorsSanjeev Arora25
Estimated H-index: 25
Abstract
Background A small number of high-need patients account for a disproportionate amount of Medicaid spending, yet typically engage little in outpatient care and have poor outcomes.
  • References (23)
  • Citations (1)
📖 Papers frequently viewed together
1 Citations
24 Citations
2008
1 Author (Regan M. Duffy)
78% of Scinapse members use related papers. After signing in, all features are FREE.
References23
Newest
#1Adam I. Biener (AHRQ: Agency for Healthcare Research and Quality)H-Index: 5
#2Samuel H. Zuvekas (AHRQ: Agency for Healthcare Research and Quality)H-Index: 25
Last. Steven C. Hill (AHRQ: Agency for Healthcare Research and Quality)H-Index: 9
view all 3 authors...
Objective To quantify the effect of Medicaid expansions on office-based care among the newly eligible. Data Source 2008–2014 Medical Expenditure Panel Survey. Study Design The main sample is adults age 26–64 with incomes ≤138% of poverty who were not eligible for Medicaid prior to the Affordable Care Act. For this population, difference-in-differences linear probability models compare utilization between expansion and nonexpansion states and between 2008–2013 and 2014. Extraction Methods Medicai...
4 CitationsSource
#1D MaengDanielH-Index: 2
#2R SnyderSusanH-Index: 2
Last. F TomcavageJanetH-Index: 2
view all 4 authors...
Abstract Adolescents and young adults with special care and health needs in the United States–many of whom have Medicaid coverage–at the transition phase between pediatric and adult care often experience critical care gaps. To address this challenge, a new model–referred to as Comprehensive Care Clinic (CCC)–has been developed and implemented by Geisinger Health System since 2012. CCC comprises a care team, consisting of a generalist physician, advanced practitioner, pharmacist, and a nurse case...
8 CitationsSource
#1Miriam Komaromy (UNM: University of New Mexico)H-Index: 15
#2Erin Fanning Madden (UTSA: University of Texas at San Antonio)H-Index: 2
Last. Sanjeev Arora (UNM: University of New Mexico)H-Index: 25
view all 8 authors...
Abstract Objective Elicit patients’ perceptions of factors that facilitate their engagement in care Methods In-depth interviews with 20 adult Medicaid patients who had complex health problems, frequent hospitalizations/emergency department use, and who were enrolled in an intensive, team-based care program designed to address medical, behavioral, and social needs. Results Prior to engaging in the program, participants described weak relationships with primary care providers, frequent hospitaliza...
3 CitationsSource
The Patient Protection and Affordable Care Act (ACA) expands access to health insurance in the United States, and, to date, an estimated 20 million previously uninsured individuals have gained coverage. Understanding the law's impact on coverage, access, utilization, and health outcomes, especially among low-income populations, is critical to informing ongoing debates about its effectiveness and implementation. Early findings indicate that there have been significant reductions in the rate of un...
22 CitationsSource
#1Stephen B. Soumerai (Harvard University)H-Index: 72
#2Rachel Ceccarelli (Harvard University)H-Index: 1
Last. Ross Koppel (UPenn: University of Pennsylvania)H-Index: 19
view all 3 authors...
Some medical scientists argue that only data from randomized controlled trials (RCTs) are trustworthy. They claim data from natural experiments and administrative data sets are always spurious and cannot be used to evaluate health policies and other population-wide phenomena in the real world. While many acknowledge biases caused by poor study designs, in this article we argue that several valid designs using administrative data can produce strong findings, particularly the interrupted time seri...
10 CitationsSource
#1Charlotte Kelly (University of Leeds)H-Index: 14
#2Claire Hulme (University of Leeds)H-Index: 25
Last. Graham Clarke (University of Leeds)H-Index: 33
view all 4 authors...
Objectives To investigate whether there is an association between differences in travel time/travel distance to healthcare services and patients9 health outcomes and assimilate the methodologies used to measure this. Design Systematic Review. We searched MEDLINE, Embase, Web of Science, Transport database, HMIC and EBM Reviews for studies up to 7 September 2016. Studies were excluded that included children (including maternity), emergency medical travel or countries classed as being in the globa...
36 CitationsSource
Five foundations aim to improve care for high-need, high-cost patients by building U.S. capabilities in three vital areas: clarifying the needs of such patients, elucidating the best ways of caring for them, and assisting with the spread of proven approaches.
105 CitationsSource
#1Susan L. HayesH-Index: 6
#2Claudia A. Salzberg (UPenn: University of Pennsylvania)H-Index: 11
Last. Gerard F. Anderson (Johns Hopkins University)H-Index: 61
view all 7 authors...
: Issue: Finding ways to improve outcomes and reduce spending for patients with complex and costly care needs requires an understanding of their unique needs and characteristics. Goal: Examine demographics and health care spending and use of services among adults with high needs, defined as people who have three or more chronic diseases and a functional limitation in their ability to care for themselves or perform routine daily tasks. Methods: Analysis of data from the 2009–2011 Medical Expendit...
22 Citations
#1Gerard Anderson (Johns Hopkins University)H-Index: 1
#2Jeromie Ballreich (Johns Hopkins University)H-Index: 6
Last. Jennifer L. Wolff (Johns Hopkins University)H-Index: 35
view all 8 authors...
: Using literature review and interviews, we have identified 8 attributes of programs, such as accountable care organizations, readmission initiatives, special needs plans, care transition programs, and patient-centered medical homes, that successfully treat high-need, high-cost patients. These 8 attributes--illustrated here with specific examples--are specific ways to target these types of individuals, promote leadership at various levels, emphasize interaction with the care coordinator, use da...
20 Citations
#1Douglas McCarthyH-Index: 15
#2Jamie RyanH-Index: 1
Last. Sarah KleinH-Index: 5
view all 3 authors...
This brief analyzes experts' reviews of evidence about care models designed to improve outcomes and reduce costs for patients with complex needs. It finds that successful models have several common attributes: targeting patients likely to benefit from the intervention; comprehensively assessing patients' risks and needs; relying on evidence-based care planning and patient monitoring; promoting patient and family engagement in self-care; coordinating care and communication among patients and prov...
23 Citations
Cited By1
Newest
#1Michael Hochman (SC: University of Southern California)H-Index: 3
#2Steven M. Asch (Stanford University)H-Index: 67
Source