{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:10:49Z","timestamp":1777932649932,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Population Health Management"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:p>\n                    As health systems attempt to contain utilization and costs, care management programs are proliferating. However, there are mixed findings on their impact. In 2018, Rhode Island initiated a care management program for dually eligible Medicare and Medicaid beneficiaries at high risk of hospitalization or institutionalization. The objective of this study is to evaluate the association between health care utilization and costs and care management for dual-eligible participants (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009169). The authors employed an interrupted time series analysis of administrative claims data using the Rhode Island All Payer Claims Database, which includes data from all major payers in the state, for 11 quarters (January 1, 2017 until September 1, 2019). On average, participants were younger (46.2% were 19\u201364 years of age vs. 41.9% of non-participants), female (71% vs. 62.6% of non-participants), and had a higher comorbidity burden (more commonly had anemia, atrial fibrillation, chronic kidney disease, chronic obstructive pulmonary disease, depression, diabetes, heart failure, hyperlipidemia, hypertension, ischemic heart disease, and stroke). Participation was associated with significantly fewer hospital admissions (118 fewer admissions per 1000 admissions per quarter; 95% confidence interval [CI] \u221211 to \u221222), and a reduction in Medicaid ($1841 less spent per quarter, 95% CI \u22122407 to \u22121275) and total ($2570 less spent per quarter; 95% CI \u2212$4645 to \u2212$495) costs. Participation was not significantly associated with a change in Emergency Department (ED) visits, preventable ED visits, Skilled Nursing Facility stays, or Medicare costs. These results suggest that targeted care management programs may provide dual-eligible beneficiaries with needed services while diverting inefficient health care utilization.\n                  <\/jats:p>","DOI":"10.1089\/pop.2022.0236","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T11:21:21Z","timestamp":1675682481000},"page":"37-45","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating a Care Management Program for Dual-Eligible Beneficiaries: Evidence from Rhode Island"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4690-3913","authenticated-orcid":false,"given":"Emma L.","family":"Tucher","sequence":"first","affiliation":[{"name":"Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P.","family":"McHugh","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA."},{"name":"Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kali S.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA."},{"name":"Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, Rhode Island, USA."},{"name":"Center of Innovation in Long Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anya R.","family":"Wallack","sequence":"additional","affiliation":[{"name":"The University of Vermont Health Network, Burlington, Vermont, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Meyers","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA."},{"name":"Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,2,14]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission. Data Book: Beneficiaries Dually Eligible for Medicaid and Medicaid. 2022. https:\/\/www.macpac.gov\/wp-content\/uploads\/2022\/02\/Beneficiaries-Dually-Eligible-for-Medicare-and-Medicaid-February-2022.pdf14 Accessed November28 2022."},{"key":"e_1_3_5_3_2","first-page":"1","article-title":"Characteristics of top-performing hospitals caring for high-need Medicare beneficiaries","volume":"00","author":"B\u00e9langer E","year":"2019","unstructured":"B\u00e9langer E, , McHugh J, , Meyers DJ, et al. Characteristics of top-performing hospitals caring for high-need Medicare beneficiaries. Popul Health Manag, 2019; 00:1\u20136.","journal-title":"Popul Health Manag"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/M17-0767"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hjdsi.2016.11.002"},{"key":"e_1_3_5_6_2","unstructured":"NORC at the University of Chicago. Spotlight on Health: Analysis of COVID-19 Impact on Medicare Advantage and Fee-for-Service Beneficiaries. 2021. https:\/\/www.norc.org\/PDFs\/ASonHealth\/20210518_NORC-Duals in COVID_FINAL.pdf Accessed September27 2022."},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0085"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/1077558719901219"},{"key":"e_1_3_5_9_2","first-page":"1","article-title":"Medicare Advantage Special Needs Plans for dual eligibles: a primer","volume":"31","author":"Milligan CJ","year":"2008","unstructured":"Milligan CJJr, , Woodcock CH. Medicare Advantage Special Needs Plans for dual eligibles: a primer. 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