TY - JOUR
AU - M. W. Knueven
AU - Y. Liu
AU - J. Kogan
AU - D. Swayze
AU - H. Stevenson
AU - S. Markwardt
AU - J. Schuster
AU - K. Williams
A1 - 
AB - BACKGROUND: A prior randomized trial assessed three care management (CM) interventions that were designed for adults at high risk of negative health outcomes following a hospital admission and implemented by a large health plan. These CM interventions positively and equivalently impacted several patient-centered outcomes over time. OBJECTIVE: Use the prior randomized trial as the basis for testing post-hospitalization utilization and cost impacts (1) across three CM models (primary analysis) and (2) for each CM model (secondary analysis). DESIGN: Post hoc comparison of three randomly assigned integrated CM interventions (IC) and a randomly selected, contemporaneous usual care control group (UC). PARTICIPANTS: Recently discharged high-risk Medicaid or dual-eligible Medicaid/Medicare members with multiple chronic conditions. INTERVENTIONS: Three CM interventions: high-tech (4-12 months of remote patient monitoring with video visits/condition-specific texts and telephonic visits; n = 365); high-touch (4-12 months of telephonic visits; n = 335); optimal discharge planning (ODP; 2-4 weeks of telephonic visits; n = 149). All three included an initial in-person visit. MAIN MEASURES: Ninety-day readmission and emergency department (ED) visit rates; 12-month member care costs (total, medical, pharmacy). KEY RESULTS: UC had access to, but rarely used, traditional health plan CM. Compared to UC members (N = 886), IC members (N = 886) had similar total cost of care (p = 0.58). IC pharmacy costs trended 93.6% higher (p = 0.06) while medical costs trended 52.5% lower (p = 0.10), despite higher 90-day ED visit rates (IC 32.4% vs. UC 25.5% UC, p = 0.001) and no impact on 90-day readmission rate (IC 16.5% vs. UC 16.3%, p = 0.90). None of the three CM interventions showed an overall comparative advantage, despite some variations in their post-discharge utilization and cost impacts. CONCLUSIONS: The three post-discharge CM interventions tested showed promise as cost-neutral interventions within a large health plan setting. CM engagement may reduce medical cost specifically despite its impact on readmissions and ED use, though further evaluations of CM interventions are needed.
AD - UPMC Health Plan, Pittsburgh, PA, USA. wingerm2@upmc.edu.; UPMC Health Plan, Pittsburgh, PA, USA.; UPMC Center for High-Value Health Care, Pittsburgh, PA, USA.; Partners in Care Foundation, San Fernando, CA, USA.
AN - 42045738
BT - J Gen Intern Med
C5 - Financing & Sustainability
DA - 04/2026
DO - 10.1007/s11606-026-10382-x
DP - NLM
ET - 20260427
JF - J Gen Intern Med
LA - eng
N2 - BACKGROUND: A prior randomized trial assessed three care management (CM) interventions that were designed for adults at high risk of negative health outcomes following a hospital admission and implemented by a large health plan. These CM interventions positively and equivalently impacted several patient-centered outcomes over time. OBJECTIVE: Use the prior randomized trial as the basis for testing post-hospitalization utilization and cost impacts (1) across three CM models (primary analysis) and (2) for each CM model (secondary analysis). DESIGN: Post hoc comparison of three randomly assigned integrated CM interventions (IC) and a randomly selected, contemporaneous usual care control group (UC). PARTICIPANTS: Recently discharged high-risk Medicaid or dual-eligible Medicaid/Medicare members with multiple chronic conditions. INTERVENTIONS: Three CM interventions: high-tech (4-12 months of remote patient monitoring with video visits/condition-specific texts and telephonic visits; n = 365); high-touch (4-12 months of telephonic visits; n = 335); optimal discharge planning (ODP; 2-4 weeks of telephonic visits; n = 149). All three included an initial in-person visit. MAIN MEASURES: Ninety-day readmission and emergency department (ED) visit rates; 12-month member care costs (total, medical, pharmacy). KEY RESULTS: UC had access to, but rarely used, traditional health plan CM. Compared to UC members (N = 886), IC members (N = 886) had similar total cost of care (p = 0.58). IC pharmacy costs trended 93.6% higher (p = 0.06) while medical costs trended 52.5% lower (p = 0.10), despite higher 90-day ED visit rates (IC 32.4% vs. UC 25.5% UC, p = 0.001) and no impact on 90-day readmission rate (IC 16.5% vs. UC 16.3%, p = 0.90). None of the three CM interventions showed an overall comparative advantage, despite some variations in their post-discharge utilization and cost impacts. CONCLUSIONS: The three post-discharge CM interventions tested showed promise as cost-neutral interventions within a large health plan setting. CM engagement may reduce medical cost specifically despite its impact on readmissions and ED use, though further evaluations of CM interventions are needed.
PY - 2026
SN - 0884-8734
ST - Effect of Integrated Care Management Interventions on Post-hospitalization Utilization and Cost Outcomes for Adults with Multiple Chronic Conditions
T1 - Effect of Integrated Care Management Interventions on Post-hospitalization Utilization and Cost Outcomes for Adults with Multiple Chronic Conditions
T2 - J Gen Intern Med
TI - Effect of Integrated Care Management Interventions on Post-hospitalization Utilization and Cost Outcomes for Adults with Multiple Chronic Conditions
U1 - Financing & Sustainability
U3 - 10.1007/s11606-026-10382-x
VO - 0884-8734
Y1 - 2026
ER -