Acute‐Care Utilization and Cost Offsets Associated With Language‐Concordant, Pharmacist‐Integrated Care Management Among High‐Need, High‐Cost Adults

Objective To estimate utilization and economic effects of a language‐concordant, pharmacist‐integrated care‐management program and examine equity by language and insurance. Study Setting and Design We conducted a retrospective cohort study emulating a target trial across four Phoenix safety‐net clinics (March 2022–September 2023) using inverse probability weighting and doubly robust Poisson difference‐in‐differences. Data Sources and Analytic Sample We linked electronic health records, payer claims, health information exchange admission‐discharge‐transfer alerts, and pharmacist logs for 526 high‐need, high‐cost adults. Enrollees ( n = 263) were matched 1:1 to otherwise eligible usual‐care comparators ( n = 263) from the same clinics and calendar period. Principal Findings Within 60 days, hospital admissions (average marginal effect [AME], −0.44; 95% confidence interval [CI], −0.60 to −0.28; incidence‐rate ratio [IRR], 0.50 [0.29–0.86]) and emergency department visits (AME, −0.16; 95% CI, −0.27 to −0.05; IRR, 0.47 [0.28–0.77]) were lower. Using standardized 2024 national unit costs and a $470 program cost, estimated net savings were $6421 per enrollee (return on investment [ROI], 13.66:1). Spanish‐preferring subgroup estimates were directionally similar, and formal interaction tests were not statistically significant. Conclusions In safety‐net clinics, this language‐concordant, pharmacist‐integrated multicomponent program was associated with lower short‐term hospital use and substantial near‐term standardized cost offsets.