Patient Navigation for Medicaid Frequent ED Users

Patient Navigation to Improve Care and Reduce Costs for High Utilizers of the Emergency Department

A large proportion of frequent ED users have Medicaid insurance. The purpose of this study is to evaluate the effectiveness of patient navigation for reducing Emergency Department (ED) visits and hospitalizations and improving patient-centered outcomes (e.g., self-reported health status, quality of life, access/barriers to care) among Medicaid patients who are high utilizers of the ED, as well as to identify best practices for engaging and providing healthcare services to underserved patients using patient navigation. This study will address needs that have been identified within the New Haven community and the local healthcare system, contribute to knowledge and literature surrounding the use of patient navigation to improve care for underserved patients and improve health system efficiency, and inform the design and development of programs that address these needs both locally and in other communities.

Inclusion Criteria:

• 4-18 ED visits per year
• Frequent ED users
• age 18 to 62
• Medicaid insurance only
• Those living in the greater New Haven area (i.e. having a zip code that matches that)

Exclusion Criteria:

• the current visit for primary psychiatric or substance abuse
• more than 50% of all ED visits in the past year for primary psychiatric or substance abuse.