Wisconsin Evaluation of Emergency Department Care Coordination

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.

ClinicalTrials.gov Identifier: NCT04550169

Recruitment Status : Recruiting

First Posted : September 16, 2020

Last Update Posted : December 27, 2021

See Contacts and Locations

Sponsor:

Information provided by (Responsible Party):

University of Wisconsin, Madison

Study Description

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.

Condition or disease	Intervention/treatment
Emergency Department Visit	Other: Intensive Care Coordination

Study Design

Layout table for study information

Study Type :	Observational
Estimated Enrollment :	3000 participants
Observational Model:	Cohort
Time Perspective:	Prospective
Official Title:	Evaluation of an Intensive Care Coordination Program to Reduce Use of Hospital Emergency Department Services by Wisconsin Medicaid Members
Actual Study Start Date :	December 17, 2021
Estimated Primary Completion Date :	February 2024
Estimated Study Completion Date :	February 2024

Groups and Cohorts

Group/Cohort	Intervention/treatment
Intensive Care Coordination Intensive Care Coordination along with Standard of Care	Other: 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
Control Standard of Care alone

Group/Cohort

Intervention/treatment

Intensive Care Coordination

Intensive Care Coordination along with Standard of Care

Other: 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

Control

Standard of Care alone

Outcome Measures

Primary Outcome Measures :

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 ]

Secondary Outcome Measures :

Total Number of Primary Care Visits [ Time Frame: 6, 12, 18, and 24 months ]
Number of Participants Who Used Any Primary Care Visits [ Time Frame: 6, 12, 18, and 24 months ]
Number of Participants Who Used Specialty Care Visits [ Time Frame: 6, 12, 18, and 24 months ]
Total Number of Specialty Care Visits [ Time Frame: 6, 12, 18, and 24 months ]
Number of Participants with Any Hospitalizations [ Time Frame: 6, 12, 18, and 24 months ]
Number of Hospitalization Events [ Time Frame: 6, 12, 18, and 24 months ]
Number of visits to use behavioral health resources, if applicable for the participant [ Time Frame: 6, 12, 18, and 24 months ]
Number of visits to use alcohol and other drug abuse resources if applicable for the participant [ Time Frame: 6, 12, 18, and 24 months ]
Total Cost Related to the Use of Behavioral Health Resources if applicable for the participant [ Time Frame: 6, 12, 18, and 24 months ]
Total Cost Related to Use of Alcohol and other Drug Abuse Resources if applicable for the participant [ Time Frame: 6, 12, 18, and 24 months ]
Total costs of care to Medicaid [ Time Frame: 6, 12, 18, and 24 months ]
Number of participants enrolled in Temporary Assistance for Needy Families (TANF) [ Time Frame: 6, 12, 18, and 24 months ]
Number of participants enrolled in FoodShare [ Time Frame: 6, 12, 18, and 24 months ]
FoodShare is a program that helps people with limited resources buy the food they need for good health.

Eligibility Criteria

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

Layout table for eligibility information

Ages Eligible for Study:	18 Years to 64 Years (Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	Yes
Sampling Method:	Non-Probability Sample

Study Population

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).

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).

Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04550169

Contacts

Layout table for location contacts

Contact: Donna Friedsam	608-265-9377	dafriedsam@wisc.edu

Locations

Layout table for location information

United States, Wisconsin
ThedaCare	Recruiting
Appleton, Wisconsin, United States, 54911
Contact: Tara Anderson 920-364-3627 Tara.Anderson@thedacare.org
Ascension Wisconsin	Recruiting
Glendale, Wisconsin, United States, 53217
Contact: Elizabeth Cliffe 414-465-3583 elizabeth.cliffe@ascension.org
Gundersen Health System	Recruiting
La Crosse, Wisconsin, United States, 54601
Contact: Jim Burmester jkburmes@gundersenhealth.org
Aurora Health Care	Recruiting
Milwaukee, Wisconsin, United States, 53202
Contact: Robert Marrs 414-345-4940 robert.marrs@aurora.org
Froedtert Health , Wisconsin	Recruiting
Wauwatosa, Wisconsin, United States, 53226
Contact: Mark Lodes mark.lodes@froedtert.com

Sponsors and Collaborators

University of Wisconsin, Madison

Investigators

Layout table for investigator information

Principal Investigator:	Rebecca Myerson, MPH, PhD	University of Wisconsin, Madison

More Information

Layout table for additonal information

Responsible Party:	University of Wisconsin, Madison
ClinicalTrials.gov Identifier:	NCT04550169
Other Study ID Numbers:	2020-1211 MSN240705 ( Other Grant/Funding Number: DHHS, CENTERS FOR MEDICARE & MEDICAID SE ) A538500 ( Other Identifier: UW Madison ) SMPH/POP HEALTH SCI/POP HEALTH ( Other Identifier: UW Madison ) Protocol Version April 2020 ( Other Identifier: UW Madison )
First Posted:	September 16, 2020 Key Record Dates
Last Update Posted:	December 27, 2021
Last Verified:	December 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD:	No

Layout table for additional information

Studies a U.S. FDA-regulated Drug Product:	No
Studies a U.S. FDA-regulated Device Product:	No

Keywords provided by University of Wisconsin, Madison:


Medicaid CARES (Wisconsin Client Assistance for Re-Employment and Economic Support)

Additional relevant MeSH terms:

Layout table for MeSH terms

Emergencies Disease Attributes Pathologic Processes

To Top