A pharmacy liaison-patient navigation intervention to reduce inpatient and emergency department utilization among primary care patients in a Medicaid accountable care organization: A pragmatic trial protocol.

2020 ◽  
Vol 94 ◽  
pp. 106046
Author(s):  
Karen E. Lasser ◽  
Pablo Buitron de la Vega ◽  
Erin M. Ashe ◽  
Ziming Xuan ◽  
Sonia Alva ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Patient Navigation ◽  
Pragmatic Trial ◽  
Accountable Care Organization ◽  
Emergency Department Utilization ◽  
Care Organization ◽  
Trial Protocol ◽  
Accountable Care ◽  
Primary Care Patients

impact of a Pharmacy-Led Transitions of Care Program Within a Primary Care-Based Accountable Care Organization

2021 ◽  
Vol 36 (6) ◽  
pp. 311-316
Author(s):  
Tina Joseph ◽  
Genevieve M. Hale ◽  
Cynthia Moreau ◽  
Stephanie L. Kourtakis ◽  
William R. Wolowich
Keyword(s):  
Primary Care ◽  
Primary Outcome ◽  
Care Setting ◽  
Primary Care Setting ◽  
Care Program ◽  
Accountable Care Organization ◽  
Transitions Of Care ◽  
Care Organization ◽  
Pharmacy Services ◽  
Accountable Care

OBJECTIVE: To assess the impact of pharmacist-led transitions of care program on 30-day readmission rates in the accountable care organization (ACO) primary care setting. DESIGN: Retrospective cohort study. SETTING: Two primary care provider (PCP) offices with an ACO in South Florida. PATIENTS, PARTICIPANTS: Adult Medicare patients who completed a post-discharge follow-up visit at two primary care offices within an ACO from July to December 2017. INTERVENTIONS: To supplement postdischarge visits with a PCP, the pharmacy services were also provided two days per week with a PCP. The comparator groups were patients who only saw a PCP or those who saw a PCP and pharmacist. MAIN OUTCOME MEASUREMENTS: The primary outcome was hospital readmission or emergency department visit within 30 days. RESULTS: A total of 190 subjects were included. There were 113 patients in the PCP group and 77 patients in the PCP/pharmacist group. There was a reduction in the primary outcome when comparing the PCP-only versus PCP/pharmacist groups (6.2% versus 3.9%; P = 0.74). CONCLUSION: Involving pharmacists in patient transitions of care in the primary care setting may be beneficial as previous studies have demonstrated. Further studies evaluating pharmacy services in emerging health care models are needed in order to most effectively utilize the expertise of the pharmacy team.

Payment Reform for Primary Care Within the Accountable Care Organization

JAMA ◽  
2012 ◽  
Vol 308 (6) ◽  
pp. 577 ◽  
Author(s):  
Allan H. Goroll ◽  
Stephen C. Schoenbaum
Keyword(s):  
Primary Care ◽  
Accountable Care Organization ◽  
Care Organization ◽  
Accountable Care ◽  
Payment Reform

scholarly journals Integrated, Accountable Care For Medicaid Expansion Enrollees: A Comparative Evaluation of Hennepin Health

2018 ◽  
Vol 77 (1) ◽  
pp. 46-59 ◽  
Author(s):  
Katherine D. Vickery ◽  
Nathan D. Shippee ◽  
Jeremiah Menk ◽  
Ross Owen ◽  
David M. Vock ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Emergency Department ◽  
Managed Care ◽  
Health Care Utilization ◽  
Emergency Department Visits ◽  
Care Utilization ◽  
Care Organization ◽  
Medicaid Expansion ◽  
Accountable Care

Hennepin Health, a Medicaid accountable care organization, began serving early expansion enrollees (very low-income childless adults) in 2012. It uses an integrated care model to address social and behavioral needs. We compared health care utilization in Hennepin Health with other Medicaid managed care in the same area from 2012 to 2014, controlling for demographics, chronic conditions, and enrollment patterns. Homelessness and substance use were higher in Hennepin Health. Overall adjusted results showed Hennepin Health had 52% more emergency department visits and 11% more primary care visits than comparators. Over time, modeling a 6-month exposure to Hennepin Health, emergency department and primary care visits decreased and dental visits increased; hospitalizations decreased nonsignificantly but increased among comparators. Subgroup analysis of high utilizers showed lower hospitalizations in Hennepin Health. Integrated, accountable care under Medicaid expansion showed some desirable trends and subgroup benefits, but overall did not reduce acute health care utilization versus other managed care.

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