The Effects of Case Management in a Medicaid Managed Care Plan

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.

Study Overview

• Status: Unknown
• Conditions: Heart Diseases; Neoplasms; Adrenal Cortex Diseases
• Intervention / Treatment: Behavioral: Case management

Detailed 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.

• Study Type: Interventional
• Enrollment: 500
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Russell E Hilliard, PhD, LCSW; Phone Number: 718-491-7214; Email: rhilliar@mjhs.org
• Study Contact Backup: Name: Eliot Fishman, PhD; Phone Number: 718-491-7134; Email: efishman@mjhs.org

Study Locations

• United States
  • New York
    • Brooklyn, New York, United States, 11220
      • Recruiting
      • Metropolitan Jewish Health System
      • Sub-Investigator: Eliot Fishman, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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 Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Non-Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
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 Outcome Measures

Outcome Measure
The outcomes for quality of life will be evaluated from the McGill Quality of Life Questionnaire.

Collaborators and Investigators

• Sponsor: Metropolitan Jewish Health System
• Investigators: Principal Investigator: Barbara Paris, MD, Maimonides Medical Center

Publications and helpful links

General Publications

• 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. doi: 10.1097/01.mlr.0000218835.78953.53.

Study record dates

Study Major Dates

• Study Start: May 1, 2006
• Primary Completion: December 7, 2022
• Study Completion: January 1, 2008

Study Registration Dates

• First Submitted: October 9, 2006
• First Submitted That Met QC Criteria: October 10, 2006
• First Posted (Estimate): October 11, 2006

Study Record Updates

• Last Update Posted (Estimate): October 11, 2006
• Last Update Submitted That Met QC Criteria: October 10, 2006
• Last Verified: October 1, 2006

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases; Endocrine System Diseases; Adrenal Gland Diseases; Heart Diseases; Adrenal Cortex Diseases
• Other Study ID Numbers: Health Plus at Home

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No