IT to Support Integration of Social Determinant of Health Services to Reduce Avoidable Emergency Department Visits
Primary Purpose
Mental Health Issue, Substance Use Disorders
Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Peer Integrated Care Services
Sponsored by
About this trial
This is an interventional supportive care trial for Mental Health Issue
Eligibility Criteria
Inclusion Criteria:
- Adults age 18 to 65
- New York State Medicaid Managed Care Members
- Have utilized emergency department services 6 or more times in a 12-month period
- Have been assigned to the Pilot Project by their Medicaid Managed Care Plan
Exclusion Criteria:
- Individuals not assigned by a Managed Care Organization meeting the above criteria
Sites / Locations
- Northern New York Rural Behavioral Health Institute
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Medicaid Emergency Department High Utilizers
Arm Description
This Arm will include the following individuals Up to 400 Adults age 18 to 65 New York State Medicaid Managed Care Members Have utilized emergency department services 6 or more times in a 12-month period Have been assigned to the Pilot Project by their Medicaid Managed Care Plan
Outcomes
Primary Outcome Measures
Change in Adoption and Use of IT Platform
Change in Number of Participating Agencies That Contribute Data to the IT System
Change in Engagement of Medicaid Member Participants with Peer Integration Care Services
The change in acceptance by Medicaid Members of Peer Integrated Care Services
Change in Total Cost of Care for Participating Members
Change in cost trend for participating members. Pre-study vs. study period.
Secondary Outcome Measures
Change in Emergency Room Visits by Participating Members
Change in rate of Emergency Department utilization by participating members.
Full Information
NCT ID
NCT04125433
First Posted
October 10, 2019
Last Updated
October 11, 2019
Sponsor
Northern New York Rural Behavioral Health Institute
1. Study Identification
Unique Protocol Identification Number
NCT04125433
Brief Title
IT to Support Integration of Social Determinant of Health Services to Reduce Avoidable Emergency Department Visits
Official Title
Use of Information Technology to Support Integration of Social Determinant of Health Services to Reduce Avoidable Emergency Department Visits
Study Type
Interventional
2. Study Status
Record Verification Date
October 2019
Overall Recruitment Status
Unknown status
Study Start Date
August 1, 2020 (Anticipated)
Primary Completion Date
June 30, 2022 (Anticipated)
Study Completion Date
August 30, 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Northern New York Rural Behavioral Health Institute
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Working through regional Accountable Care Organizations (ACO) the sponsor will establish a 2-year pilot project to demonstrate that early recognition and intervention in the various Social Determinant of Health (SDoH) domains can reduce avoidable Emergency Department (ED) visits by high utilizers. The regional ACO's will contract with Medicaid Managed Care Plans to assign traditional high ED utilizing members to the pilot project. Members will be offered enhanced peer facilitated care management services connecting members with available SDoH community based services. Members fitting our eligibility criteria will self-select by way of completing a pilot project consent form.
Detailed Description
The project employs a two level intervention to include Peer Support Specialist (PSS) and Community Health Advocate (CHA). Contact and engagement with participating members will be through both direct intervention in the emergency department by Peer Support Specialist (the peer) as well as in the community for prevention visits and follow up by both the peer and Community Health Advocate. These well-positioned Peers and Community Health Advocates will address Behavioral and Social Determinants of Health (SDoH) concerns through a highly coordinated intervention supported by a common IT Medicaid member tracking platform. This research project will determine the feasibility of deploying a single shared IT platform that will include referral, appointment completion, and intervention outcome data. Project staff will develop a trusting relationship with the members and will improve member access and engagement with community-based services. The project will also seek to determine the impact on total cost of care through redirecting study participants to community resources that are more appropriate, and less expensive than return visits to the emergency department.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mental Health Issue, Substance Use Disorders
7. Study Design
Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
In this study a Medicaid Managed Care Plan will identify up to 400 plan members who have visited an emergency department greater than 6 time in a 12-month period. These individuals will receive enhanced integrated peer care services and will be tracked across health and social service venues using a single IT platform. This study will examine the impact of this intervention on total cost of care.
Masking
None (Open Label)
Allocation
N/A
Enrollment
400 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Medicaid Emergency Department High Utilizers
Arm Type
Experimental
Arm Description
This Arm will include the following individuals
Up to 400 Adults age 18 to 65
New York State Medicaid Managed Care Members
Have utilized emergency department services 6 or more times in a 12-month period
Have been assigned to the Pilot Project by their Medicaid Managed Care Plan
Intervention Type
Behavioral
Intervention Name(s)
Peer Integrated Care Services
Intervention Description
The project employs a two level intervention to include Peer Support Specialist (PSS) and Community Health Advocate (CHA). Contact and engagement with participating members will be through both direct intervention in the emergency department as well as in the community for prevention visits and follow up. Peers and Community Health Advocates will address Behavioral and Social Determinants of Health (SDoH) concerns through a coordinated intervention supported by a common IT Medicaid member tracking platform. This research project will determine the feasibility of deploying a single shared IT platform that will include referral, appointment completion, and intervention outcome data. Project staff will develop a relationship with the members improving member access and engagement with community-based services. The project will determine the impact on total cost of care through redirecting study participants to community resources rather than return visits to the emergency department.
Primary Outcome Measure Information:
Title
Change in Adoption and Use of IT Platform
Description
Change in Number of Participating Agencies That Contribute Data to the IT System
Time Frame
Months 6, 12, 18, 24
Title
Change in Engagement of Medicaid Member Participants with Peer Integration Care Services
Description
The change in acceptance by Medicaid Members of Peer Integrated Care Services
Time Frame
Months 0, 3, 6, 9, 12, 15, 18, 21, 24
Title
Change in Total Cost of Care for Participating Members
Description
Change in cost trend for participating members. Pre-study vs. study period.
Time Frame
Month 0, Month 24
Secondary Outcome Measure Information:
Title
Change in Emergency Room Visits by Participating Members
Description
Change in rate of Emergency Department utilization by participating members.
Time Frame
Month 0, 6, 12,18,24
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Adults age 18 to 65
New York State Medicaid Managed Care Members
Have utilized emergency department services 6 or more times in a 12-month period
Have been assigned to the Pilot Project by their Medicaid Managed Care Plan
Exclusion Criteria:
Individuals not assigned by a Managed Care Organization meeting the above criteria
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Barry Brogan, MAPP
Phone
518-891-9460
Email
barry@behaviorhealthnet.orh
First Name & Middle Initial & Last Name or Official Title & Degree
Robert Cawley, BBA
Phone
518-891-9460
Email
robert@behaviorhealthnet.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Cawley, BBA
Organizational Affiliation
Northern NY Rural Behavioral Health Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Northern New York Rural Behavioral Health Institute
City
Saranac Lake
State/Province
New York
ZIP/Postal Code
12983
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Barry Brogan, MAPP
Phone
518-891-9460
Email
barry@behaviorhealthnet.org
First Name & Middle Initial & Last Name & Degree
Robert Cawley, BBA
Phone
518-891-9460
Email
robert@behaviorhealthnet.org
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
IT to Support Integration of Social Determinant of Health Services to Reduce Avoidable Emergency Department Visits
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