Wisconsin Evaluation of Emergency Department Care Coordination

Emergency Department Visit Clinical Trial

Official title:

Evaluation of an Intensive Care Coordination Program to Reduce Use of Hospital Emergency Department Services by Wisconsin Medicaid Members

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT04550169
• Other study ID #: 2020-1211
• Secondary ID: MSN240705A538500
• Status: Active, not recruiting
• Start date: March 1, 2022
• Est. completion date: December 2024

Study information

• Verified date: April 2024
• Source: University of Wisconsin, Madison
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

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.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 3267
• Est. completion date: December 2024
• Est. primary completion date: December 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 64 Years

Eligibility

Inclusion Criteria:

• Adults who are Medicaid enrolled

• Have had 5+ emergency department visits in the past year

Exclusion Criteria:

• Participants who are concurrently eligible for Medicare

• Children (individuals age <18 years).

Related Conditions & MeSH terms

• Emergencies
• Emergency Department Visit

Intervention

Other:
• Intensive Care Coordination
Intensive care coordination will include: Discharge instructions and contacts for following up on care and treatment Referral information Appointment scheduling Medication instructions Intensive care coordination by a social worker, case manager, nurse, or care coordinator to connect Medical Assistance (MA) recipient to a primary care provider or to a managed care organization Information about other health and social resources, such as transportation and housing Sharing of information (discharge instructions, medication information, and care plan information) with managed care organization in which patients are enrolled, if applicable

Locations

Country	Name	City	State
United States	ThedaCare	Appleton	Wisconsin
United States	Ascension Wisconsin	Glendale	Wisconsin
United States	Aurora Health Care	Milwaukee	Wisconsin
United States	Froedtert Health , Wisconsin	Wauwatosa	Wisconsin

Sponsors (1)

Lead Sponsor	Collaborator
University of Wisconsin, Madison

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Total Number of Emergency Department Visits		6 months
Primary	Total Number of Emergency Department Visits		12 months
Primary	Total Number of Emergency Department Visits		18 months
Primary	Total Number of Emergency Department Visits		24 months
Primary	Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions		6 months
Primary	Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions		12 months
Primary	Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions		18 months
Primary	Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions		24 months
Primary	Cost to Medicaid for all Emergency Department Visits		6 months
Primary	Cost to Medicaid for all Emergency Department Visits		12 months
Primary	Cost to Medicaid for all Emergency Department Visits		18 months
Primary	Cost to Medicaid for all Emergency Department Visits		24 months
Primary	Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions		6 months
Primary	Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions		12 months
Primary	Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions		18 months
Primary	Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions		24 months
Secondary	Total Number of Primary Care Visits		6, 12, 18, and 24 months
Secondary	Number of Participants Who Used Any Primary Care Visits		6, 12, 18, and 24 months
Secondary	Number of Participants Who Used Specialty Care Visits		6, 12, 18, and 24 months
Secondary	Total Number of Specialty Care Visits		6, 12, 18, and 24 months
Secondary	Number of Participants with Any Hospitalizations		6, 12, 18, and 24 months
Secondary	Number of Hospitalization Events		6, 12, 18, and 24 months
Secondary	Number of visits to use behavioral health resources, if applicable for the participant		6, 12, 18, and 24 months
Secondary	Number of visits to use alcohol and other drug abuse resources if applicable for the participant		6, 12, 18, and 24 months
Secondary	Total Cost Related to the Use of Behavioral Health Resources if applicable for the participant		6, 12, 18, and 24 months
Secondary	Total Cost Related to Use of Alcohol and other Drug Abuse Resources if applicable for the participant		6, 12, 18, and 24 months
Secondary	Total costs of care to Medicaid		6, 12, 18, and 24 months
Secondary	Number of participants enrolled in Temporary Assistance for Needy Families (TANF)		6, 12, 18, and 24 months
Secondary	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