Impact on Health Care Utilization and Costs of a Medicaid Community Health Worker Program in Detroit, 2018–2020

A Randomized Program Evaluation

Bibliographic Data

ID11022672
AuthorsMichele Heisler (0000-0002-6889-2063, Michele Heisler is with the University of Michigan Medical School, Ann Arbor. Adrienne Lapidos is with the University of Michigan Department of Psychiatry, Ann Arbor. Edith Kieffer is with the University of Michigan School of Social Work, Ann Arbor. James Henderson is with the University of Michigan Consulting for Statistics, Computing and Analytics Research, Ann Arbor. Rebeca Guzman is with the Detroit Health Department, Detroit, MI. Jasmina Cunmulaj is with the University of Michigan School of Public...), Adrienne Lapidos (0000-0003-4202-162X, Michele Heisler is with the University of Michigan Medical School, Ann Arbor. Adrienne Lapidos is with the University of Michigan Department of Psychiatry, Ann Arbor. Edith Kieffer is with the University of Michigan School of Social Work, Ann Arbor. James Henderson is with the University of Michigan Consulting for Statistics, Computing and Analytics Research, Ann Arbor. Rebeca Guzman is with the Detroit Health Department, Detroit, MI. Jasmina Cunmulaj is with the University of Michigan School of Public...), Edith Kieffer (Michele Heisler is with the University of Michigan Medical School, Ann Arbor. Adrienne Lapidos is with the University of Michigan Department of Psychiatry, Ann Arbor. Edith Kieffer is with the University of Michigan School of Social Work, Ann Arbor. James Henderson is with the University of Michigan Consulting for Statistics, Computing and Analytics Research, Ann Arbor. Rebeca Guzman is with the Detroit Health Department, Detroit, MI. Jasmina Cunmulaj is with the University of Michigan School of Public...), Edith C Kieffer (0000-0002-1162-6178, University of Michigan), James Henderson (0000-0001-8467-8916, Michele Heisler is with the University of Michigan Medical School, Ann Arbor. Adrienne Lapidos is with the University of Michigan Department of Psychiatry, Ann Arbor. Edith Kieffer is with the University of Michigan School of Social Work, Ann Arbor. James Henderson is with the University of Michigan Consulting for Statistics, Computing and Analytics Research, Ann Arbor. Rebeca Guzman is with the Detroit Health Department, Detroit, MI. Jasmina Cunmulaj is with the University of Michigan School of Public...), Rebeca Guzmán (Michele Heisler is with the University of Michigan Medical School, Ann Arbor. Adrienne Lapidos is with the University of Michigan Department of Psychiatry, Ann Arbor. Edith Kieffer is with the University of Michigan School of Social Work, Ann Arbor. James Henderson is with the University of Michigan Consulting for Statistics, Computing and Analytics Research, Ann Arbor. Rebeca Guzman is with the Detroit Health Department, Detroit, MI. Jasmina Cunmulaj is with the University of Michigan School of Public...), Jasmina Cunmulaj (0000-0002-3229-8134, Michele Heisler is with the University of Michigan Medical School, Ann Arbor. Adrienne Lapidos is with the University of Michigan Department of Psychiatry, Ann Arbor. Edith Kieffer is with the University of Michigan School of Social Work, Ann Arbor. James Henderson is with the University of Michigan Consulting for Statistics, Computing and Analytics Research, Ann Arbor. Rebeca Guzman is with the Detroit Health Department, Detroit, MI. Jasmina Cunmulaj is with the University of Michigan School of Public...), J Wolfe (0000-0003-1584-0283, University of Michigan), Trish Meyer (Michele Heisler is with the University of Michigan Medical School, Ann Arbor. Adrienne Lapidos is with the University of Michigan Department of Psychiatry, Ann Arbor. Edith Kieffer is with the University of Michigan School of Social Work, Ann Arbor. James Henderson is with the University of Michigan Consulting for Statistics, Computing and Analytics Research, Ann Arbor. Rebeca Guzman is with the Detroit Health Department, Detroit, MI. Jasmina Cunmulaj is with the University of Michigan School of Public...), John Z Ayanian (Michele Heisler is with the University of Michigan Medical School, Ann Arbor. Adrienne Lapidos is with the University of Michigan Department of Psychiatry, Ann Arbor. Edith Kieffer is with the University of Michigan School of Social Work, Ann Arbor. James Henderson is with the University of Michigan Consulting for Statistics, Computing and Analytics Research, Ann Arbor. Rebeca Guzman is with the Detroit Health Department, Detroit, MI. Jasmina Cunmulaj is with the University of Michigan School of Public...)
Year2022
Volume112
Issue5
Pages766-775
Publication date2022-05-01
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2021.306700
PMID35324259
OpenAlexW4220918672
LanguageEN
Citations received3
References cited25

Objectives. To compare health care utilization and costs between beneficiaries randomly assigned to usual services versus a community health worker (CHW) program implemented by 3 Medicaid health plans. Methods. From February 2018 to June 2019, beneficiaries residing in Detroit, Michigan’s Cody Rouge neighborhood with more than 3 emergency department (ED) visits or at least 1 ambulatory care‒sensitive hospitalization in the previous 12 months were randomized. CHWs reached out to eligible beneficiaries to assess their needs and link them to services. We compared ED and ambulatory care visits, hospitalizations, and related costs over 12 months. Results. In intention-to-treat analyses among 2457 beneficiaries, the 1389 randomized to the CHW program had lower adjusted ratios of ED visits (adjusted rate ratio [ARR] = 0.96; P Conclusions. Initial increases in ambulatory care use from effective programs for underserved communities may mitigate savings from decreased acute care use. Longer-term outcomes should be followed to assess potential cost savings from improved health. Trial Registration: ClinicalTrials.gov identifier: NCT03924713. (Am J Public Health. 2022;112(5):766–775. https://doi.org/10.2105/AJPH.2021.306700 )

Ambulatory · Ambulatory care · Emergency department · Environmental health · Family medicine · Health care · Medicaid · Public health · Randomized controlled trial · Emergency Medicine · Food Security and Health in Diverse Populations · Healthcare Policy and Management · Medicine · Nursing · Primary Care and Health Outcomes · Gerontology

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