Reducing Emergency Department Visits among Dual Eligible Patients via a Comprehensive Wellness Assessment

Barbara Guerard, Vincent Omachonu, Bisakha Sen

Research output: Contribution to journalArticle

Abstract

The objective was to assess whether a Comprehensive Wellness Assessment (CWA) is associated with reduced emergency department (ED) visits for Special Needs Program (SNP) enrollees with diabetes. This retrospective panel study used a Medicare Advantage plan's administrative claims data for 2010-2017 and pooled member-month observations. Multivariate regression and individual fixed-effects regression models were estimated. The outcome was ED visits measured as binary and continuous outcomes. Data were derived from claims data that included at least 1 ICD-9 or 10 code between January 2010 and December 2017. Regression results indicated that SNP enrollees completing a CWA was associated with a lower probability of any monthly ED use (β = -0.005, t-stat = -2.98) and fewer monthly visits (β = -0.008, t-stat = -2.95). Individual fixed-effects models also demonstrated a significant decline in SNP ED use after a CWA, though the strongest effects were confined to the first 4 months after a CWA. Care models with components such as CWAs may contribute an additional benefit in the form of a reduction in ED utilization. Completing a CWA appears to be effective in reducing ED utilization among SNP members with diabetes.

Original languageEnglish (US)
Pages (from-to)415-421
Number of pages7
JournalPopulation Health Management
Volume22
Issue number5
DOIs
StatePublished - Oct 2019

Keywords

  • dual eligible
  • elderly
  • population health
  • utilization
  • wellness assessment

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Public Health, Environmental and Occupational Health

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