TY - JOUR
AU - S. R. Sioni
AU - L. Manson
AU - N. Arledge
AU - J. Yanez
AU - Al Mouslmani
A1 - 
AB - OBJECTIVE: To estimate utilization and economic effects of a language-concordant, pharmacist-integrated care-management program and examine equity by language and insurance. STUDY SETTING AND DESIGN: We conducted a retrospective cohort study emulating a target trial across four Phoenix safety-net clinics (March 2022-September 2023) using inverse probability weighting and doubly robust Poisson difference-in-differences. DATA SOURCES AND ANALYTIC SAMPLE: We linked electronic health records, payer claims, health information exchange admission-discharge-transfer alerts, and pharmacist logs for 526 high-need, high-cost adults. Enrollees (n = 263) were matched 1:1 to otherwise eligible usual-care comparators (n = 263) from the same clinics and calendar period. PRINCIPAL FINDINGS: Within 60 days, hospital admissions (average marginal effect [AME], -0.44; 95% confidence interval [CI], -0.60 to -0.28; incidence-rate ratio [IRR], 0.50 [0.29-0.86]) and emergency department visits (AME, -0.16; 95% CI, -0.27 to -0.05; IRR, 0.47 [0.28-0.77]) were lower. Using standardized 2024 national unit costs and a $470 program cost, estimated net savings were $6421 per enrollee (return on investment [ROI], 13.66:1). Spanish-preferring subgroup estimates were directionally similar, and formal interaction tests were not statistically significant. CONCLUSIONS: In safety-net clinics, this language-concordant, pharmacist-integrated multicomponent program was associated with lower short-term hospital use and substantial near-term standardized cost offsets.
AD - College of Health Solutions, Arizona State University, Phoenix, Arizona, USA.; Miami Herbert Business School, University of Miami, Coral Gables, Florida, USA.; Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA.; Merit Health River Region, Vicksburg, Mississippi, USA.; Nicklaus Children's Hospital, Miami, Florida, USA.; Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, Florida, USA.; Department of Hospital Medicine, Yale New Haven Hospital, New Haven, Connecticut, USA.
AN - 42114840
BT - Health Serv Res
C5 - Education & Workforce; Financing & Sustainability
CP - 3
DA - 06/2026
DO - 10.1111/1475-6773.70127
DP - NLM
IS - 3
JF - Health Serv Res
LA - eng
N2 - OBJECTIVE: To estimate utilization and economic effects of a language-concordant, pharmacist-integrated care-management program and examine equity by language and insurance. STUDY SETTING AND DESIGN: We conducted a retrospective cohort study emulating a target trial across four Phoenix safety-net clinics (March 2022-September 2023) using inverse probability weighting and doubly robust Poisson difference-in-differences. DATA SOURCES AND ANALYTIC SAMPLE: We linked electronic health records, payer claims, health information exchange admission-discharge-transfer alerts, and pharmacist logs for 526 high-need, high-cost adults. Enrollees (n = 263) were matched 1:1 to otherwise eligible usual-care comparators (n = 263) from the same clinics and calendar period. PRINCIPAL FINDINGS: Within 60 days, hospital admissions (average marginal effect [AME], -0.44; 95% confidence interval [CI], -0.60 to -0.28; incidence-rate ratio [IRR], 0.50 [0.29-0.86]) and emergency department visits (AME, -0.16; 95% CI, -0.27 to -0.05; IRR, 0.47 [0.28-0.77]) were lower. Using standardized 2024 national unit costs and a $470 program cost, estimated net savings were $6421 per enrollee (return on investment [ROI], 13.66:1). Spanish-preferring subgroup estimates were directionally similar, and formal interaction tests were not statistically significant. CONCLUSIONS: In safety-net clinics, this language-concordant, pharmacist-integrated multicomponent program was associated with lower short-term hospital use and substantial near-term standardized cost offsets.
PY - 2026
SN - 0017-9124 (Print); 0017-9124
SP - e70127
ST - Acute-Care Utilization and Cost Offsets Associated With Language-Concordant, Pharmacist-Integrated Care Management Among High-Need, High-Cost Adults
T1 - Acute-Care Utilization and Cost Offsets Associated With Language-Concordant, Pharmacist-Integrated Care Management Among High-Need, High-Cost Adults
T2 - Health Serv Res
TI - Acute-Care Utilization and Cost Offsets Associated With Language-Concordant, Pharmacist-Integrated Care Management Among High-Need, High-Cost Adults
U1 - Education & Workforce; Financing & Sustainability
U3 - 10.1111/1475-6773.70127
VL - 61
VO - 0017-9124 (Print); 0017-9124
Y1 - 2026
ER -