{"title":"管理式医疗与经济适用房合作模式对急症护理成本的评估。","authors":"Jack Tsai, Suja Rajan, Chau Truong, Vanessa Schick, Cecilia Ganduglia Cazaban","doi":"10.37765/ajmc.2024.89514","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated a collaborative service model between the largest Medicaid managed care organization (MCO) in Texas, Superior HealthPlan, and the affordable housing provider Prospera Housing Community Services.</p><p><strong>Study design: </strong>Using a quasi-experimental 2-groups research design, we compared health care outcomes and costs between a sample of 104 participants served by the Prospera+Superior collaborative model and a group of 104 participants who had health care coverage through the Superior HealthPlan Medicaid MCO but did not live at Prospera properties (ie, Superior-only group).</p><p><strong>Methods: </strong>Data from medical claims were analyzed to examine change in outcomes 12 months before and after implementation of the Prospera+Superior collaborative model in 2019.</p><p><strong>Results: </strong>The Prospera+Superior group had a 56% lower rate of emergency department/urgent care visits and spent $2061 less in prescription costs than the Superior-only group after implementation.</p><p><strong>Conclusions: </strong>These findings provide needed evidence of the clinical and economic value of forming multisector collaborative models between MCOs and other community providers.</p>","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of a collaborative model between managed care and affordable housing on acute care costs.\",\"authors\":\"Jack Tsai, Suja Rajan, Chau Truong, Vanessa Schick, Cecilia Ganduglia Cazaban\",\"doi\":\"10.37765/ajmc.2024.89514\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study evaluated a collaborative service model between the largest Medicaid managed care organization (MCO) in Texas, Superior HealthPlan, and the affordable housing provider Prospera Housing Community Services.</p><p><strong>Study design: </strong>Using a quasi-experimental 2-groups research design, we compared health care outcomes and costs between a sample of 104 participants served by the Prospera+Superior collaborative model and a group of 104 participants who had health care coverage through the Superior HealthPlan Medicaid MCO but did not live at Prospera properties (ie, Superior-only group).</p><p><strong>Methods: </strong>Data from medical claims were analyzed to examine change in outcomes 12 months before and after implementation of the Prospera+Superior collaborative model in 2019.</p><p><strong>Results: </strong>The Prospera+Superior group had a 56% lower rate of emergency department/urgent care visits and spent $2061 less in prescription costs than the Superior-only group after implementation.</p><p><strong>Conclusions: </strong>These findings provide needed evidence of the clinical and economic value of forming multisector collaborative models between MCOs and other community providers.</p>\",\"PeriodicalId\":50808,\"journal\":{\"name\":\"American Journal of Managed Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Managed Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.37765/ajmc.2024.89514\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Managed Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.37765/ajmc.2024.89514","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
研究目的本研究评估了德克萨斯州最大的医疗补助管理式医疗机构 Superior HealthPlan 与经济适用房提供商 Prospera Housing Community Services 之间的合作服务模式:研究设计:我们采用准实验性两组研究设计,比较了 Prospera+Superior 合作模式服务的 104 名参与者样本与通过 Superior HealthPlan 医疗补助 MCO 获得医疗保险但不住在 Prospera 房地产的 104 名参与者样本(即仅有 Superior 组)的医疗结果和成本:方法:分析医疗索赔数据,研究2019年实施Prospera+Superior合作模式前后12个月的结果变化:结果:实施后,Prospera+Superior组的急诊科/急诊就诊率比Superior组低56%,处方费用比Superior组低2061美元:这些研究结果提供了必要的证据,证明在 MCO 和其他社区医疗服务提供者之间形成多部门合作模式的临床和经济价值。
Evaluation of a collaborative model between managed care and affordable housing on acute care costs.
Objectives: This study evaluated a collaborative service model between the largest Medicaid managed care organization (MCO) in Texas, Superior HealthPlan, and the affordable housing provider Prospera Housing Community Services.
Study design: Using a quasi-experimental 2-groups research design, we compared health care outcomes and costs between a sample of 104 participants served by the Prospera+Superior collaborative model and a group of 104 participants who had health care coverage through the Superior HealthPlan Medicaid MCO but did not live at Prospera properties (ie, Superior-only group).
Methods: Data from medical claims were analyzed to examine change in outcomes 12 months before and after implementation of the Prospera+Superior collaborative model in 2019.
Results: The Prospera+Superior group had a 56% lower rate of emergency department/urgent care visits and spent $2061 less in prescription costs than the Superior-only group after implementation.
Conclusions: These findings provide needed evidence of the clinical and economic value of forming multisector collaborative models between MCOs and other community providers.
期刊介绍:
The American Journal of Managed Care is an independent, peer-reviewed publication dedicated to disseminating clinical information to managed care physicians, clinical decision makers, and other healthcare professionals. Its aim is to stimulate scientific communication in the ever-evolving field of managed care. The American Journal of Managed Care addresses a broad range of issues relevant to clinical decision making in a cost-constrained environment and examines the impact of clinical, management, and policy interventions and programs on healthcare and economic outcomes.