Wisconsin Evaluation of Emergency Department Care Coordination

University of Wisconsin, Madison3,405 enrolled

Overview

The State of Wisconsin is now expanding its investment in care coordination models as an effort to reduce inappropriate hospital emergency department (ED) use, improve health outcomes, and reduce Medicaid expenditures. This effort begins with a pilot program to support emergency department care coordination in hospitals and health systems that apply and are selected to participate in the pilot program. The Wisconsin Medicaid program seeks to understand whether this program achieves its intended goals and, specifically, whether the Medicaid payment for such care coordination services produces the intended program outcomes. Hospitals will select members that will receive care coordination services. In a quasi-experimental approach, the study team will compare members that do vs. do not receive the services will be used examine the effects of care coordination and referrals on total ED visits, primary-care treatable ED visits, non-emergent ED visits, and health care costs, as well as the specific effects of referring patients to providers who offer low-cost and after-hours care. To assess the importance of targeting, study team will conduct stratified analyses of vulnerable groups such as people with disabilities and individuals with specific clinical needs.

Study Type

OBSERVATIONAL

Enrollment

3,405

Conditions

Emergency Department Visit

Interventions

Intensive care coordination will include: * Discharge instructions and contacts for following up on care and treatment * Referral information * Appointment scheduling * Medication instructions * Intensive care coordination by a social worker, case manager, nurse, or care coordinator to connect Medical Assistance (MA) recipient to a primary care provider or to a managed care organization * Information about other health and social resources, such as transportation and housing * Sharing of information (discharge instructions, medication information, and care plan information) with managed care organization in which patients are enrolled, if applicable

Locations (4)

ThedaCare

Appleton, Wisconsin, United States

Ascension Wisconsin

Glendale, Wisconsin, United States

Aurora Health Care

Milwaukee, Wisconsin, United States

Froedtert Health , Wisconsin

Wauwatosa, Wisconsin, United States

Outcomes

Primary Outcomes

Total Number of Emergency Department Visits

Time frame: 6 months

Total Number of Emergency Department Visits

Time frame: 12 months

Total Number of Emergency Department Visits

Time frame: 18 months

Total Number of Emergency Department Visits

Time frame: 24 months

Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions

Time frame: 6 months

Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions

Time frame: 12 months

Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions

Time frame: 18 months

Total Number of Emergency Department Visits for Primary Care Preventable and/or Non-Emergent Conditions

Time frame: 24 months

Cost to Medicaid for all Emergency Department Visits

Time frame: 6 months

Cost to Medicaid for all Emergency Department Visits

Time frame: 12 months

Cost to Medicaid for all Emergency Department Visits

Time frame: 18 months

Cost to Medicaid for all Emergency Department Visits

Time frame: 24 months

Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions

Time frame: 6 months

Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions

Time frame: 12 months

Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions

Time frame: 18 months

Cost to Medicaid for Emergency Department Use for Primary Care Preventable and/or Non-Emergent Conditions

Time frame: 24 months