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Trends in Costs of Care and Utilization for Medicaid Patients with Diabetes in Accountable Care Communities: A Natural Experiment for Translation in Diabetes (NEXT-D) 2 Study
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June 2020
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Source: Med Care. 58(Suppl 6 1):S40-S45
[PDF-93.92 KB]
Details:
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Alternative Title:Med Care
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Personal Author:
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Description:Background/Objectives:
Medicaid beneficiaries with diabetes have complex care needs. The Accountable Care Communities (ACC) Program is a practice-level intervention implemented by UnitedHealthcare to improve care for Medicaid beneficiaries. We examined changes in costs and utilization for Medicaid beneficiaries with diabetes assigned to ACC versus usual care practices.
Research Design:
Interrupted time series with concurrent control group analysis, at the person-month level. The ACC was implemented in 14 states, and we selected comparison non-ACC practices from those states to control for state-level variation in Medicaid program. We adjusted the models for age, gender, race/ethnicity, comorbidities, seasonality, and state-by-year fixed effects. We examined the difference between ACC and non-ACC practices in changes in the time trends of expenditures and hospital and emergency room utilization, for the four largest categories of Medicaid eligibility (Temporary Assistance to Needy Families, Supplemental Security Income (without Medicare), Expansion, Dual-Eligible).
Subjects/Measures:
Eligibility and claims data from Medicaid adults with diabetes from 14 states between 2010–2016, before and after ACC implementation.
Results:
Analyses included 1,200,460 person-months from 66,450 Medicaid patients with diabetes. ACC implementation was not associated with significant changes in outcome time trends, relative to comparators, for all Medicaid categories.
Conclusions:
Medicaid patients assigned to ACC practices had no changes in cost or utilization over three years follow-up, compared to patients assigned to non-ACC practices. The ACC program may not reduce costs or utilization for Medicaid patients with diabetes.
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Source:
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Pubmed ID:32412952
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Pubmed Central ID:PMC8260093
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Volume:58
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