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Program implementation strategies associated with reduced acute care utilization for Medicaid beneficiaries in California's Whole Person Care pilot program

Chuang E, Yue D, O'Masta B, Haley LA, Zhou W, Pourat N
Med Care Res Rev

Public health care policymakers and payers are increasingly investing in efforts to address patients' health-related social needs (HRSNs) as a strategy for improving health while controlling or reducing costs. However, evidence regarding the implementation and impact of HRSN interventions remains limited. California's Whole Person Care Pilot program (WPC) was a Medicaid Section 1115 waiver demonstration program focused on the provision of care coordination and other services to address eligible beneficiaries' HRSN. In this study, we examine pilot-level variation in impact on acute care utilization and identify factors associated with differential outcomes. The majority of pilots reduced emergency department (ED) visits for enrollees relative to matched controls; however, only four pilots reduced both ED visits and hospitalizations. Coincidence analysis results highlight the importance of cross-sector partnerships, field-based outreach and engagement, and adequate program investment in differentiating pilots that reduced acute care utilization from those that did not.

Chuang E, Yue D, O'Masta B, Haley LA, Zhou W, Pourat N. Program implementation strategies associated with reduced acute care utilization for Medicaid beneficiaries in California's Whole Person Care pilot program. Med Care Res Rev. 2024 Sep 3:10775587241273404. Epub ahead of print. DOI:10.1177/10775587241273404. PMID: 39225361

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Publication year
Resource type
Peer Reviewed Research
Outcomes
Utilization
Population
Medicaid-insured
Social Determinant of Health
Not Specified
Study design
Other Study Design