title: The effect of a telephone-based health coaching disease management program on Medicaid members with chronic conditions.
abstract: BACKGROUND
  Despite the growing popularity of disease management programs for chronic conditions, evidence regarding the effect of these programs has been mixed. In addition, few peer-reviewed studies have examined the effect of these programs on publicly insured populations.
  
  
  OBJECTIVE
  To examine the effect of a telephone-based health coaching disease management program on healthcare utilization and expenditures in Medicaid members with chronic conditions.
  
  
  METHODS
  Using a difference-in-differences analysis, we examined changes in hospitalizations, emergency department (ED) visits, ambulatory care visits, and Medicaid expenditures among program members for 1 year before and 2 years after their enrollment compared with a matched comparison group.
  
  
  METHODS
  Medicaid members aged 18 to 64 with a diagnosis of qualifying chronic conditions and 2 acute health service events of hospitalizations and/or ED visits within a 12-month period.
  
  
  RESULTS
  Changes in acute hospitalizations, ambulatory care visits, and Medicaid expenditures before and after program enrollment were similar between the 2 study groups. However, during the second year after enrollment, program members had a significantly smaller decrease in ED visits than the comparisons (8% in program members and 23% in comparisons, P value=0.03).
  
  
  CONCLUSIONS
  Compared with a matched comparison group, the telephone-based health coaching disease management program did not demonstrate significant effects on healthcare utilization and expenditures in Medicaid members with chronic conditions.
authors: Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA 01545, USA. wen.lin@umassmed.edu
authors: Wen-Chieh
authors: WC
authors: Lin
authors: Hung-Lun
authors: HL
authors: Chien
authors: Georgianna
authors: G
authors: Willis
authors: Elizabeth
authors: E
authors: O'Connell
authors: Kate Staunton
authors: KS
authors: Rennie
authors: Heather M
authors: HM
authors: Bottella
authors: Timothy G
authors: TG
authors: Ferris
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease / Q000191:economics / Q000628:therapy*; D019468:Disease Management; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics / Q000458:organization & administration*; D008875:Middle Aged; D013689:Telephone; D014481:United States; D055815:Young Adult