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| ID | Type | Description | Link |
|---|---|---|---|
| MSN240705 | Other Grant/Funding Number | DHHS, CENTERS FOR MEDICARE & MEDICAID SE | |
| A538500 | Other Identifier | UW Madison | |
| SMPH/POP HEALTH SCI/POP HEALTH | Other Identifier | UW Madison | |
| Protocol Version April 2020 | Other Identifier | UW Madison |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intensive Care Coordination | Intensive Care Coordination along with Standard of Care |
| |
| Control | Standard of Care alone |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intensive Care Coordination | Other | Intensive care coordination will include:
|
| Measure | Description | Time Frame |
|---|---|---|
| Total Number of Emergency Department Visits | 6 months | |
| Total Number of Emergency Department Visits | 12 months | |
| Total Number of Emergency Department Visits | 18 months | |
| Total Number of Emergency Department Visits | 24 months | |
| Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions | 6 months | |
| Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions | 12 months | |
| Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions | 18 months | |
| Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions | 24 months | |
| Cost to Medicaid for all Emergency Department Visits | 6 months | |
| Cost to Medicaid for all Emergency Department Visits | 12 months | |
| Cost to Medicaid for all Emergency Department Visits |
| Measure | Description | Time Frame |
|---|---|---|
| Total Number of Primary Care Visits | 6, 12, 18, and 24 months | |
| Number of Participants Who Used Any Primary Care Visits | 6, 12, 18, and 24 months | |
| Number of Participants Who Used Specialty Care Visits |
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Inclusion Criteria:
Exclusion Criteria:
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Rebecca Myerson, MPH, PhD | University of Wisconsin, Madison | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| ThedaCare | Appleton | Wisconsin | 54911 | United States | ||
| Ascension Wisconsin |
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|
| 18 months |
| Cost to Medicaid for all Emergency Department Visits | 24 months |
| Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions | 6 months |
| Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions | 12 months |
| Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions | 18 months |
| Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions | 24 months |
| 6, 12, 18, and 24 months |
| Total Number of Specialty Care Visits | 6, 12, 18, and 24 months |
| Number of Participants with Any Hospitalizations | 6, 12, 18, and 24 months |
| Number of Hospitalization Events | 6, 12, 18, and 24 months |
| Number of visits to use behavioral health resources, if applicable for the participant | 6, 12, 18, and 24 months |
| Number of visits to use alcohol and other drug abuse resources if applicable for the participant | 6, 12, 18, and 24 months |
| Total Cost Related to the Use of Behavioral Health Resources if applicable for the participant | 6, 12, 18, and 24 months |
| Total Cost Related to Use of Alcohol and other Drug Abuse Resources if applicable for the participant | 6, 12, 18, and 24 months |
| Total costs of care to Medicaid | 6, 12, 18, and 24 months |
| Number of participants enrolled in Temporary Assistance for Needy Families (TANF) | 6, 12, 18, and 24 months |
| Number of participants enrolled in FoodShare | FoodShare is a program that helps people with limited resources buy the food they need for good health. | 6, 12, 18, and 24 months |
| Glendale |
| Wisconsin |
| 53217 |
| United States |
| Aurora Health Care | Milwaukee | Wisconsin | 53202 | United States |
| Froedtert Health , Wisconsin | Wauwatosa | Wisconsin | 53226 | United States |