Wisconsin Evaluation of Emergency Department Care Coordination

NCT ID: NCT04550169

Last Updated: 2025-01-10

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 3405 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2022-03-01
• Study Completion Date: 2024-12-15

Brief Summary

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.

Conditions

Emergency Department Visit

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Intensive Care Coordination

Intensive Care Coordination along with Standard of Care

Intensive Care Coordination

Intervention Type: OTHER

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

Control

Standard of Care alone

No interventions assigned to this group

Interventions

Intensive Care Coordination

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

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Adults who are Medicaid enrolled
• Have had 5+ emergency department visits in the past year

Exclusion Criteria

• Participants who are concurrently eligible for Medicare
• Children (individuals age <18 years).

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 64 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

University of Wisconsin, Madison

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Rebecca Myerson, MPH, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Wisconsin, Madison

Locations

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

Countries

United States

Other Identifiers

MSN240705

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

A538500

Identifier Type: OTHER

Identifier Source: secondary_id

SMPH/POP HEALTH SCI/POP HEALTH

Identifier Type: OTHER

Identifier Source: secondary_id

Protocol Version April 2020

Identifier Type: OTHER

Identifier Source: secondary_id

2020-1211

Identifier Type: -

Identifier Source: org_study_id