TY - JOUR
AU - D. W. Roblin
AU - J. E. Segel
AU - H. Hu
AU - N. Mendiratta
A1 - 
AB - BACKGROUND/OBJECTIVE: Evidence about the patient benefits of alternative primary care delivery models for high-cost/high needs patients is mixed. We conducted a follow-up study of a program designed to improve outcomes of seriously ill adult patients in an integrated delivery system. METHODS: Using a quasi-experimental design, we examined the 180-day mortality of patients empaneled to a complex care program (CCP, n=1445) compared with that of eligible but unempaneled patients who continued to receive usual primary care (UPC, n=6409) for January 2019 through June 2021. Patients in the CCP and UPC were propensity score-matched on demographics, comorbidities, and frailty. In the propensity score matched samples (n=1440 in each group), the hazard of mortality was estimated using Cox proportional hazards regression. RESULTS: The CCP continued to empanel eligible adults with more comorbidities and greater frailty compared with the eligible patient population in UPC. In the matched samples, CCP patients had a significantly lower hazard of 180-day mortality compared with UPC in this replication cohort (0.71, 95% CI: 0.61-0.82). This was higher than the hazard ratio in the prior inception cohort (0.58, 95% CI: 0.47-0.70). CONCLUSIONS: A reduced hazard of death was reproduced within a second incident cohort of among seriously ill adult patients who were empaneled to a CCP in an integrated health care system compared with matched, but unempaneled patients whose care remained within UPC.
AD - Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD.; Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, University Park, PA.; Mid-Atlantic Permanente Medical Group PC, Kaiser Permanente, Rockville, MD.
AN - 41503876
BT - Med Care
C5 - Healthcare Disparities
CP - 2
DA - Feb 1
DO - 10.1097/mlr.0000000000002256
DP - NLM
ET - 20260108
IS - 2
JF - Med Care
LA - eng
N2 - BACKGROUND/OBJECTIVE: Evidence about the patient benefits of alternative primary care delivery models for high-cost/high needs patients is mixed. We conducted a follow-up study of a program designed to improve outcomes of seriously ill adult patients in an integrated delivery system. METHODS: Using a quasi-experimental design, we examined the 180-day mortality of patients empaneled to a complex care program (CCP, n=1445) compared with that of eligible but unempaneled patients who continued to receive usual primary care (UPC, n=6409) for January 2019 through June 2021. Patients in the CCP and UPC were propensity score-matched on demographics, comorbidities, and frailty. In the propensity score matched samples (n=1440 in each group), the hazard of mortality was estimated using Cox proportional hazards regression. RESULTS: The CCP continued to empanel eligible adults with more comorbidities and greater frailty compared with the eligible patient population in UPC. In the matched samples, CCP patients had a significantly lower hazard of 180-day mortality compared with UPC in this replication cohort (0.71, 95% CI: 0.61-0.82). This was higher than the hazard ratio in the prior inception cohort (0.58, 95% CI: 0.47-0.70). CONCLUSIONS: A reduced hazard of death was reproduced within a second incident cohort of among seriously ill adult patients who were empaneled to a CCP in an integrated health care system compared with matched, but unempaneled patients whose care remained within UPC.
PY - 2026
SN - 0025-7079
SP - 45
EP - 49+
ST - Comparative Effectiveness of a Complex Care Program for High-Cost/High-Need Patients: A Replication Study
T1 - Comparative Effectiveness of a Complex Care Program for High-Cost/High-Need Patients: A Replication Study
T2 - Med Care
TI - Comparative Effectiveness of a Complex Care Program for High-Cost/High-Need Patients: A Replication Study
U1 - Healthcare Disparities
U3 - 10.1097/mlr.0000000000002256
VL - 64
VO - 0025-7079
Y1 - 2026
ER -