title: Care coordination program for Washington State Medicaid enrollees reduced inpatient hospital costs.
abstract: Managing clinically complex populations poses a major challenge for state agencies trying to control health care costs and improve quality of care for Medicaid beneficiaries. In Washington State a care coordination intervention, the Chronic Care Management program, was implemented for clinically complex Medicaid beneficiaries who met risk criteria defined by a predictive modeling algorithm. We used propensity score matching to evaluate the program's impact on health care spending and utilization and mortality. We found large and significant reductions in inpatient hospital costs ($318 per member per month) among patients who used the program. The estimated reduction in overall medical costs of $248 per member per month exceeded the cost of the intervention but did not reach statistical significance. These results suggest that well-designed targeted care coordination services could reduce health care spending for Medicaid beneficiaries with complex health care needs.
authors.affiliation: Jingping Xing is a research investigator in the Research and Data Analysis Division, Washington State Department of Social and Health Services, in Olympia.
authors.forename: Jingping
authors.initials: J
authors.lastname: Xing
authors.affiliation: Candace Goehring is chief of the Office of Service Integration, Behavioral Health and Service Integration Administration, in the Washington State Department of Social and Health Services.
authors.forename: Candace
authors.initials: C
authors.lastname: Goehring
authors.affiliation: David Mancuso (David.Mancuso@dshs.wa.gov) is director of the Research and Data Analysis Division, Washington State Department of Social and Health Services.
authors.forename: David
authors.initials: D
authors.lastname: Mancuso
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000191:economics* / Q000706:statistics & numerical data; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D010346:Patient Care Management / Q000191:economics / Q000458:organization & administration*; D057216:Propensity Score; D014481:United States; D014861:Washington
keywords: Care coordination; Cost of Health Care; Medicaid; Mortality