TY - JOUR
KW - Adult
KW - Community Health Services/economics/organization & administration/utilization
KW - Cost Savings
KW - Female
KW - Humans
KW - Male
KW - Medicaid
KW - Models, Economic
KW - North Carolina
KW - Organizational Case Studies
KW - Patient-Centered Care/economics
KW - United States
AU - H. Fillmore
AU - C. A. Dubard
AU - G. A. Ritter
AU - C. T. Jackson
A1 - 
AB - This study evaluated the financial impact of integrating a systemic care management intervention program (Community Care of North Carolina) with person-centered medical homes throughout North Carolina for non-elderly Medicaid recipients with disabilities during almost 5 years of program history. It examined Medicaid claims for 169,676 non-elderly Medicaid recipients with disabilities from January 2007 through third quarter 2011. Two models were used to estimate the program's impact on cost, within each year. The first employed a mixed model comparing member experiences in enrolled versus unenrolled months, accounting for regional differences as fixed effects and within physician group experience as random effects. The second was a pre-post, intervention/comparison group, difference-in-differences mixed model, which directly matched cohort samples of enrolled and unenrolled members on strata of preenrollment pharmacy use, race, age, year, months in pre-post periods, health status, and behavioral health history. The study team found significant cost avoidance associated with program enrollment for the non-elderly disabled population after the first years, savings that increased with length of time in the program. The impact of the program was greater in persons with multiple chronic disease conditions. By providing targeted care management interventions, aligned with person-centered medical homes, the Community Care of North Carolina program achieved significant savings for a high-risk population in the North Carolina Medicaid program.
BT - Population health management
C5 - Medical Home; Financing & Sustainablity
CP - 3
CY - United States
DO - 10.1089/pop.2013.0055
IS - 3
JF - Population health management
N2 - This study evaluated the financial impact of integrating a systemic care management intervention program (Community Care of North Carolina) with person-centered medical homes throughout North Carolina for non-elderly Medicaid recipients with disabilities during almost 5 years of program history. It examined Medicaid claims for 169,676 non-elderly Medicaid recipients with disabilities from January 2007 through third quarter 2011. Two models were used to estimate the program's impact on cost, within each year. The first employed a mixed model comparing member experiences in enrolled versus unenrolled months, accounting for regional differences as fixed effects and within physician group experience as random effects. The second was a pre-post, intervention/comparison group, difference-in-differences mixed model, which directly matched cohort samples of enrolled and unenrolled members on strata of preenrollment pharmacy use, race, age, year, months in pre-post periods, health status, and behavioral health history. The study team found significant cost avoidance associated with program enrollment for the non-elderly disabled population after the first years, savings that increased with length of time in the program. The impact of the program was greater in persons with multiple chronic disease conditions. By providing targeted care management interventions, aligned with person-centered medical homes, the Community Care of North Carolina program achieved significant savings for a high-risk population in the North Carolina Medicaid program.
PP - United States
PY - 2014
SN - 1942-7905
SP - 141
EP - 148
EP - 
T1 - Health care savings with the patient-centered medical home: Community Care of North Carolina's experience
T2 - Population health management
TI - Health care savings with the patient-centered medical home: Community Care of North Carolina's experience
U1 - Medical Home; Financing & Sustainablity
U2 - 24053757
U3 - 10.1089/pop.2013.0055
VL - 17
VO - 1942-7905
Y1 - 2014
ER -