Managed Care Results from Kaiser Permanente Oakland Medical Center Described (Factors Associated with High and Persistent Health Care Utilization in Managed Medicaid): Managed Care


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2021 OCT 28 (NewsRx) – By a Journalist-Staff News Editor at Daily Insurance News – The results of the managed care research are discussed in a new report. According to information from Oakland, California, per NewsRx correspondents, the research said, “Previous studies have had difficulty predicting which patients will have persistently high use over the past year in the Medicaid population. The objective of this study was to examine medical diagnoses at the time of enrollment of patients with persistent high healthcare utilization for 24 months after enrollment in Medicaid managed care in a large integrated care setting.

Funding support for this research includes the Kaiser Permanente Northern California Community Benefit program, Permanent Medical Group through the Health Care Delivery and Policy Section at Kaiser Permanente Research Division.

Our editors got a research citation from Oakland Kaiser Permanente Medical Center, “Retrospective cohort study in a large integrated and managed health care system. We identified a cohort of heavy users (5% highest healthcare costs in 2014) and extracted data from their electronic health records (2014-2016). Differences in the baseline characteristics of heavy users and the general Medicaid population were determined using bivariate analysis. We used multivariate regression to determine the independent association between medical co-morbidities and demographics with persistently high healthcare utilization over the 2 years after enrollment. Compared to the general population of Medicaid-managed care registrants, schizophrenia was the only mental health diagnosis at the time of registration associated with high and persistent health care use (risk ratio [RR], 1.50; 95% CI, 1.20-1.86). Additional characteristics associated with persistent high use included age between 31 and 50 years (RR, 1.20; 95% CI, 1.02-1.41), dual enrollment in Medicaid and Medicare (RR, 1 , 26; 95% CI, 1.09-1.45), chronic pain diagnoses (RR, 1.26; 95% CI, 1.04-1.53) and multimorbidity (RR, 1.43 ; 95% CI, 1.25-1.63).

According to the editors, the research concluded, “Among adults newly enrolled in Medicaid managed care, some diagnoses noted at the time of enrollment in the plan are associated with high and persistent healthcare use over the past 2 years. early years, suggesting that targeting early supportive case management to these individuals could optimize care and reduce health care costs.

This research has been peer reviewed.

For more information on this research, see: Factors Associated with High and Persistent Healthcare Use in Managed Medicaid. The American Journal of Managed Care, 2021; 27 (8). The American Journal of Managed Care can be contacted at: Managed Care & Healthcare Communications Llc, 666 Plainsboro Road, Ste 300, Plainsboro, New Jersey 08536, United States.

The editors report that additional information can be obtained by contacting Somalee Banerjee, Oakland Kaiser Permanente Medical Center, Specialty based on hospital service, Oakland, California 94611, United States. Other authors of this research include Amy Alabaster, Patricia kipnis and Alyce S. Adams.

The direct object identifier (DOI) for this additional information is: https://doi.org/10.37765/ajmc.2021.88725. This DOI is a link to an electronic document online that is free or to purchase, and can be your direct source for a journal article and its citation.

(Our reports provide factual information on research and discoveries from around the world.)

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