The Effects of Case Management in a Medicaid Managed Care Plan

Heart Diseases Clinical Trial

Official title:

The Effects of Case Management in a Medicaid Managed Care Plan

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT00385879
• Other study ID #: Health Plus at Home
• Status: Recruiting
• Phase: N/A
• First received: October 9, 2006
• Last updated: October 10, 2006
• Start date: May 2006
• Est. completion date: January 2008

Study information

• Verified date: October 2006
• Source: Metropolitan Jewish Health System
• Contact: Russell E Hilliard, PhD, LCSW
• Phone: 718-491-7214
• Email: rhilliar[@]mjhs.org
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to evaluate whether or not case management by a social worker and nurse can decrease the number of emergency room visits, increase the number of primary care doctor visits, and increase quality of life of people in a Medicaid managed care plan.

Description:

This study will assign participants based on Zip Code to one of two conditions: control and experimental. In the control group, participants will receive telephonic assessments at baseline, three months, and six months. These assessments will be conducted by a member of the Medical Center’s Department of Geriatrics under the supervision of the Principal Investigator. Participants in the experimental group will receive medical case management provided by a nurse and social worker in the homecare setting including an in-home assessment. Assessments will be conducted at baseline, three months, and six months during routine homecare visits. Dependent variables being measured include: access to primary care physicians, emergent hospitalizations/admissions, articulation of advance directives, and quality of life. Data will be collected through the participants’ medical claims and records to analyze the number of emergent hospitalizations/admissions, documentation of advance directives, and number of visits to primary care physicians. To measure participants’ quality of life, the Depression Self-Rating Scale and the Clinical Anxiety Scale will be utilized. Data will be compared between and within the groups via statistical analyses. The researcher will conduct pre-post comparisons of utilization and other database-derived outcomes for both groups, comparing the 12 months prior to and up to 20 months following enrollment.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 500
• Est. completion date: January 2008
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• participation in a Medicaid managed care plan

• resident of identified zip codes in Brooklyn, NY

• frequent hospitalizations and low frequency of primary doctor visits

Exclusion Criteria:

• residents outside the catchment area

• patients not being managed in a Medicaid managed care plan

Study Design

Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Supportive Care

Related Conditions & MeSH terms

• Adrenal Cortex Diseases
• Heart Diseases
• Neoplasms

Intervention

Behavioral:
• Case management

Locations

Country	Name	City	State
United States	Metropolitan Jewish Health System	Brooklyn	New York

Sponsors (1)

Lead Sponsor	Collaborator
Metropolitan Jewish Health System

Country where clinical trial is conducted

United States, 

References & Publications (1)

Chattopadhyay A, Bindman AB. The contribution of Medicaid managed care to the increasing undercount of Medicaid beneficiaries in the Current Population Survey. Med Care. 2006 Sep;44(9):822-6. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The outcome measure for the number of emergency room visits will be calculated from the medical record counting the number of hospital emergency room visits; for access to primary physicians, the medical record will be reviewed as well.
Secondary	The outcomes for quality of life will be evaluated from the McGill Quality of Life Questionnaire.