High Health Care-utilizing Medicaid Beneficiaries Clinical Trial
Official title:
Evaluation of a Community Health Worker (CHW)-Led Comprehensive Neighborhood-Based Program for Medicaid Enrollees in Detroit
The investigators are comparing health care utilization claims data of Medicaid beneficiaries who participated in a CHW program led by three Medicaid health plans' salaried CHWs in the Cody Rouge neighborhood of Detroit, Michigan with eligible beneficiaries who were not invited to participate in the program but received usual health plan services.
This program evaluation examines the effectiveness, barriers and facilitators of implementing
a geographically targeted program led by salaried CHWs from three Medicaid health plans in
collaboration with the Detroit Health Department and Joy Southfield Community Development
Corporation. Beneficiaries who reside in the Cody Rouge neighborhood and had more than 3
Emergency Department (ED) visits or at least 1 ambulatory care-sensitive hospitalization in
the prior 12 months are randomized to the CHW program or to usual outreach from the health
plans. CHWs reach out to eligible beneficiaries to provide a comprehensive assessment of
health, behavioral, and social needs; link them to needed resources; and provide necessary
follow-up. At 12- month follow up, health plan claims data on ED visits, ambulatory
care-sensitive hospitalizations, primary care visits and all related costs will be compared
between participants who participated in this program compared with other participants who
would have been eligible but were not offered the program (with no effort to contact them).
The investigators hypothesize that patients enrolled in the CHW intervention will experience
a reduction in acute care usage resulting in cost savings compared to those receiving usual
health plan CHW outreach. This study is among the first to evaluate the impact on health care
utilization of augmented services delivered by health plan CHWs for high-utilizing health
plan members. This study will provide important information on the sustainability of future
health plan CHW programs and provide insights into effective implementation of such programs.
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