University of California, Berkeley, USA.
University of Maryland, College Park, USA.
Med Care Res Rev. 2024 Dec;81(6):432-443. doi: 10.1177/10775587241273404. Epub 2024 Sep 3.
Public health care policymakers and payers are increasingly investing in efforts to address patients' health-related social needs (HRSNs) as a strategy for improving health while controlling or reducing costs. However, evidence regarding the implementation and impact of HRSN interventions remains limited. California's Whole Person Care Pilot program (WPC) was a Medicaid Section 1115 waiver demonstration program focused on the provision of care coordination and other services to address eligible beneficiaries' HRSN. In this study, we examine pilot-level variation in impact on acute care utilization and identify factors associated with differential outcomes. The majority of pilots reduced emergency department (ED) visits for enrollees relative to matched controls; however, only four pilots reduced both ED visits and hospitalizations. Coincidence analysis results highlight the importance of cross-sector partnerships, field-based outreach and engagement, and adequate program investment in differentiating pilots that reduced acute care utilization from those that did not.
公共医疗保健政策制定者和支付者越来越多地投资于解决患者健康相关社会需求（HRSN）的努力，作为改善健康同时控制或降低成本的一种策略。然而，有关 HRSN 干预措施的实施和影响的证据仍然有限。加利福尼亚州的整体患者护理试点计划（WPC）是一项医疗补助第 1115 节豁免示范计划，侧重于提供护理协调和其他服务，以解决符合条件的受益人的 HRSN。在这项研究中，我们检查了试点层面在对急性护理利用的影响方面的差异，并确定了与不同结果相关的因素。与匹配的对照组相比，大多数试点项目减少了参保者的急诊就诊次数；然而，只有四个试点项目减少了急诊就诊次数和住院次数。巧合分析结果强调了跨部门合作、基于现场的外展和参与，以及在区分减少急性护理利用的试点项目和未减少的试点项目方面适当的项目投资的重要性。
