Key result
High intensity managed care links to lower ED use but higher readmissions versus fee-for-service.
Why the study?
Hospitalized adult Medicaid recipients with chronic disease are at risk for rehospitalization within 90 days, but most research has focused on the Medicare population.
Does high intensity managed care organization intervention reduce 90-day inpatient readmissions in adult Medicaid recipients with chronic disease?
Population
2,868 adult Medicaid recipients with chronic disease from 2012 New York State Medicaid Data Warehouse
Comparison
High intensity managed care organization interventions vs low intensity fee-for-service management
Design
Retrospective cohort analysis
Follow-up
90 days
Authors
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Readmission rates may be a flawed quality indicator in complex Medicaid populations; leaves open the optimal managed care model for chronic disease.
Cohort (n=2,868)
Does high intensity managed care organization intervention reduce 90-day inpatient readmissions in adult Medicaid recipients with chronic disease?
In Medicaid adults with chronic disease, high-intensity managed care interventions unexpectedly increased readmission rates despite lowering ED visits, suggesting readmission may be a flawed quality indicator in this complex population.
Hewner et al. (2016) conducted a cohort in Chronic disease (n=2,868). High intensity managed care organization interventions vs. Low intensity fee-for-service management was evaluated on 90-day post-discharge utilization (inpatient readmissions, outpatient, and emergency department). High intensity managed care interventions were associated with higher outpatient and lower emergency department utilization, but higher readmission rates compared to fee-for-service management.
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