TY - JOUR
AU - N. Pourat
AU - W. Zhou
AU - L. A. Haley
AU - J. Ryan
AU - A. Sripipatana
A1 - 
AB - The authors aimed to investigate potential differences between health care use and related payments for patients with complex needs and high costs in Health Resources and Services Administration-funded health centers (HCs) and with other safety net primary care providers. The authors used data from the California Health Homes Program that was designed to improve health outcomes and reduce expenditures of such Medicaid managed care beneficiaries. The authors used 2018 data prior to program implementation and conducted propensity score-matched regressions. The authors then estimated predicted rates of use across seven service categories and payment values for each category and for overall payments. The authors found that 29% of the sample were HC patients and had lower estimated average total payment values ($21,220) than group provider patients ($23,180). HC patients also had lower values for hospitalizations and long-term facility stays and higher values for primary and mental health services than all other providers. Payment differences were generally consistent with differences in predicted rates of use. These findings suggest that HC approaches to managing patient care access and integrated mental health services may explain these differences in use and payment patterns.
AD - Department of Health Policy and Management, University of California Los Angeles Jonathan and Karin Fielding School of Public Health, Los Angeles, California, USA.; Center for Health Policy Research, University of California Los Angeles, Los Angeles, California, USA.; U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Primary Health Care, Rockville, Maryland, USA.
AN - 40014406
BT - Popul Health Manag
C5 - Healthcare Policy; Financing & Sustainability
CP - 3
DA - Jun
DO - 10.1089/pop.2024.0241
DP - NLM
ET - 20250227
IS - 3
JF - Popul Health Manag
LA - eng
N2 - The authors aimed to investigate potential differences between health care use and related payments for patients with complex needs and high costs in Health Resources and Services Administration-funded health centers (HCs) and with other safety net primary care providers. The authors used data from the California Health Homes Program that was designed to improve health outcomes and reduce expenditures of such Medicaid managed care beneficiaries. The authors used 2018 data prior to program implementation and conducted propensity score-matched regressions. The authors then estimated predicted rates of use across seven service categories and payment values for each category and for overall payments. The authors found that 29% of the sample were HC patients and had lower estimated average total payment values ($21,220) than group provider patients ($23,180). HC patients also had lower values for hospitalizations and long-term facility stays and higher values for primary and mental health services than all other providers. Payment differences were generally consistent with differences in predicted rates of use. These findings suggest that HC approaches to managing patient care access and integrated mental health services may explain these differences in use and payment patterns.
PY - 2025
SN - 1942-7891
SP - 117
EP - 124+
ST - Health Resources and Services Administration-Funded Health Centers Reduce Health Care Expenditures of California Medicaid Managed Care Beneficiaries with Complex Needs
T1 - Health Resources and Services Administration-Funded Health Centers Reduce Health Care Expenditures of California Medicaid Managed Care Beneficiaries with Complex Needs
T2 - Popul Health Manag
TI - Health Resources and Services Administration-Funded Health Centers Reduce Health Care Expenditures of California Medicaid Managed Care Beneficiaries with Complex Needs
U1 - Healthcare Policy; Financing & Sustainability
U3 - 10.1089/pop.2024.0241
VL - 28
VO - 1942-7891
Y1 - 2025
ER -