Intensive care management of a complex Medicaid population: a randomized evaluation.

Objectives: Care management programs are employed by providers and payers to support high-risk patients and affect cost and utilization, with varied implementation. This study sought to evaluate the impact of an intensive care management program on utilization and cost among those with highest cost (top 5%) and highest utilization in a Medicaid accountable care organization (ACO) population.

Study Design: Randomized controlled quality improvement trial of intensive care management, provided by a nonprofit care management vendor, for Medicaid ACO patients at 2 academic centers.

Using claims for long-term services and support to predict mortality and hospital use.

Background: Despite limitations in their clinical content, claims data from administering health plans can provide important insights about service use and outcomes across large populations. However, using claims data to investigate care and outcomes among persons with disability is challenging because standard diagnosis, procedure, and medication codes provide little information about functional impairments or disability.

Objective: To explore whether supportive services claims provide useful information for predicting health care outcomes among persons with chronic disease and disability.

Meal Delivery Programs Reduce The Use Of Costly Health Care In Dually Eligible Medicare And Medicaid Beneficiaries.

Delivering food to nutritionally vulnerable patients is important for addressing these patients' social determinants of health. However, it is not known whether food delivery programs can reduce the use of costly health services and decrease medical spending among these patients. We sought to determine whether home delivery of either medically tailored meals or nontailored food reduces the use of selected health care services and medical spending in a sample of adults dually eligible for Medicare and Medicaid.

The critical components of an electronic care plan tool for primary care: an exploratory qualitative study.

Background: A critical need exists for effective electronic tools that facilitate multidisciplinary care for complex patients in patient-centered medical homes.Objective To identify the essential components of a primary care (PC) based electronic care plan (ECP) tool that facilitates coordination of care for complex patients.

Method: Three focus groups and nine semi-structured interviews were conducted at an academic PC practice in order to identify the ideal components of an ECP.

A migraine management training program for primary care providers: An overview of a survey and pilot study findings, lessons learned, and considerations for further research.

Background: There are five to nine million primary care office visits a year for migraine in the United States. However, migraine care is often suboptimal in the primary care setting. A prior study indicated that primary care physicians (PCPs) wanted direct contact with headache specialists to improve the migraine care they provide.

A population management system for improving colorectal cancer screening in a primary care setting.

Rationale: Provision of colorectal cancer (CRC) screening in primary care is suboptimal; failure to observe screening guidelines poses unnecessary risks to patients and doctors.

Aims And Objectives: Implement a population management system for CRC screening; evaluate impact on compliance with evidence-based guidelines.

Design: A quasi-experimental, prospective quality improvement study design using pre-post-analyses with concurrent controls.

Migraine diagnosis and treatment: A knowledge and needs assessment among primary care providers.

Background: Studies reveal that migraine is often under-recognized, misdiagnosed and inadequately treated in the primary care setting.

Objective: The objective of this article is to assess primary care providers' (PCP) knowledge and needs regarding migraine diagnosis and management.

Methods: We held semi-structured group interviews and distributed a brief questionnaire to PCPs in our hospital network.

Implementation of a collaborative care management program with buprenorphine in primary care: a comparison between opioid-dependent patients and patients with chronic pain using opioids nonmedically.

Objective: To implement a collaborative care management program with buprenorphine in a primary care clinic.

Design: Prospective observational study.

Setting: A busy urban academic primary care clinic affiliated with a tertiary care hospital.