Structuring the Integration of Care Management Services For Medicaid Enrollees Recipients With Chronic Illness, Substance Abuse Problems and Possible Psychiatric Disorders

NCT00399373 | Terminated

• 2 other identifiers: NA_00001352100326 (CHCS)
• Study Type: observational
• Target: 258
• Locations: 1 country
• Sites: 1

Brief Summary

The study seeks to measure the effect of increased coordination of care on medical costs, treatment utilization and selected clinical indicators among a Medicaid population with chronic medical conditions and substance abuse problems? We shall address this question by conducting a demonstration project consisting of the provision of integrated care management (somatic and behavioral) to Medicaid enrollees living on the Eastern Shore of Maryland and who have both chronic medical conditions and problems with substance abuse. A specific component of the study will be the participation of Maryland's Mental Health Administration (MHA) and MAPS, the administrator of psychiatric services for the Medicaid enrollees in Maryland. We shall compare the results of the integrated care management for the study sample on the Eastern Shore with a control group from the counties of western Maryland.

Conditions

Chronic Illness

Keywords

disease management; substance abuse

Outcome Measures

Primary Outcomes (1)

• Total medical costs (per member per month)

  monthly average, calculated at the end of 12 months

Study Arms (2)

Quality Improvement Initiative

The initial step in the quality improvement initiative was a letter sent from JHHC Care Management Department to the quality improvement initiative group, inviting them to take advantage of the case management services that are part of their current benefits in the Priority Partners MCO. It is similar to the standard letter sent to PPMCO members who are appropriate for a JHHC disease or case management program. A substance abuse outreach staff initiated telephonic contact with the members in the intervention group. The staff member then refered to substance abuse treatment when possible and appropriate and refered to medical case management.

Control group

No additional improvement modalities

Eligibility Criteria

• Age: 21 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

We determined the size of the quality improvement initiative sample by the case management resources available at JHHC. Without adding personnel, the maximum number of new cases that can be assumed by the 3.5 (FTE) JHHC case managers for the Eastern Shore is 130.

You may qualify if:

• years of age or older;
• Resident of one of the following Maryland counties: Caroline, Cecil, Kent, Queen Anne's, Talbot, Dorchester, Somerset, Wicomico, Worcester, Allegheny, Frederick, Garrett, Washington, Calvert, Charles, or St. Mary's; or
• Chronic medical condition(s) identified by ACG Case Mix software (e.g. an ACG score =\> 0.10) as likely to incur high costs in the following year; and
• Substance use problem in the past 27 months as indicated by an ICD-9 code or CPT code on DHMH list for Special Needs Population.
• \) Enrolled in or eligible for enrollment in a Special Needs disease management program at JHHC: HIV/AIDS, Partners with Mom, Omega Life. It is necessary to exclude these programs because PPMCO members are already receiving intensive care management.

Sponsors & Collaborators

• Johns Hopkins University: lead

Study Sites (1)

Johns Hopkins HealthCare LLC

Glen Burnie, Maryland, 21060, United States

Location

MeSH Terms

Conditions

Chronic Disease; Substance-Related Disorders

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Chemically-Induced Disorders; Mental Disorders

Study Officials

• Peter J Fagan, PhD

  Johns Hopkins School of Medicine

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 13, 2006
• First Posted: November 14, 2006
• Study Start: November 1, 2005
• Primary Completion: October 1, 2008
• Study Completion: October 1, 2008
• Last Updated: December 7, 2017

Record last verified: 2017-12

Locations

US (1)