{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T14:35:05Z","timestamp":1783434905223,"version":"3.54.6"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"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":["J Prim Care Community Health"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Chronic Kidney disease (CKD) accounts for approximately 82\u2009billion dollars of Medicare spend. Implementing culturally competent, community-based programs may be a strategy for changing utilization behaviors and lowering cost while maintaining quality in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A longitudinal claims based study was carried out from April 2023 to August 2024 in the state of CA to assess the impact of the program on cost, utilization, and quality metrics. A propensity matched approach was leveraged yielding of 203 pairs of CKD Medicare Advantage (MA) enrollees. A comparison of the difference of differences was performed between utilization, and available claims-based quality metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Enrollees in the peer support program, Connect For Life (CFL) generated significantly lower costs of $461\u2009pmpm (95% CI\u2009=\u2009\u22121037 to \u221210\u2009037;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.016) significantly lower inpatient utilization of 172\u2009per 1000 (95% CI\u2009=\u2009\u221210 to \u2212330;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.037) and significantly higher outpatient utilization of 1212\u2009per 1000 (95% CI\u2009=\u200990 to 2340;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.035). No differences were found in available quality metrics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>For CKD MA enrollees in the intervention population, more efficient utilization patterns and lower costs while maintaining quality were observed. The tight propensity match left the study underpowered to detect significant changes for other care settings or individual stages of CKD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319251347133","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T05:24:09Z","timestamp":1750137849000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The Impact of Trusted Community Navigators in Improving Care Utilization Patterns for a Population With Chronic Kidney Disease Enrolled in Medicare Advantage: A Longitudinal Claims Based Study"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9976-8068","authenticated-orcid":false,"given":"Claude","family":"Pinnock","sequence":"first","affiliation":[{"name":"Wider Circle, Redwood City, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Gordon","sequence":"additional","affiliation":[{"name":"Wider Circle, Redwood City, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Ziskin","sequence":"additional","affiliation":[{"name":"Wider Circle, Redwood City, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Carlough","sequence":"additional","affiliation":[{"name":"Wider Circle, Redwood City, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Wake","sequence":"additional","affiliation":[{"name":"Wider Circle, Redwood City, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Centers for Medicare and Medicaid Services. 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In United States Renal Data System 2023 Annual Data Report: Chronic Kidney Disease (Chapter 2). 2023. Accessed March 1 2025. https:\/\/usrds-adr.niddk.nih.gov\/2023\/chronic-kidney-disease\/2-identification-and-care-of-patients-with-ckd"},{"key":"e_1_3_3_13_2","unstructured":"National Center for Biotechnology Information. Understanding and addressing social needs. n.d. Accessed March 1 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK53914\/"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-023-03055-7"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182111557"},{"key":"e_1_3_3_16_2","unstructured":"C3 Project. Community health worker training: CHW skills. n.d. Accessed March 1 2025. https:\/\/chwtraining.org\/c3-project-chw-skills\/1"},{"key":"e_1_3_3_17_2","unstructured":"National Academy for State Health Policy. State community health worker policies: California. n.d. 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