Loading...
The Impact of Integrated Care on Healthcare Utilization and Costs: Evidence from the Kansas Health Homes Medicaid Program
Sand, Jessica Kay
Sand, Jessica Kay
Citations
Altmetric:
Abstract
In the US, just one percent of patients are responsible for over 20 percent of healthcare expenditures, with 5 percent contributing to nearly half of the nation's healthcare spending. This small group of high-cost patients includes individuals with complex conditions, encompassing multiple physical and mental health issues. These patients require numerous health and social services that are not effectively co-delivered by the current US healthcare system. They rely heavily on expensive healthcare services such as hospital admissions and emergency department visits. Integrated care programs, which aim to coordinate primary and mental health care to assist patients and caregivers in managing physical and mental health conditions, have emerged as a promising model to improve the care of complex patients while reducing costs.
I analyzed the effects of the Kansas Health Home (KHH) Medicaid program using Kansas Medicaid claims and administrative data. My study focused on the program's impact on healthcare services utilization and the per member per month (PMPM) costs within the Kansas Medicaid system. To establish potential causal relationships, I utilized the implementation of KHH as a natural experiment and employed a difference-in-differences methodology to compare outcomes between treatment and control groups. Additionally, I performed a series of robustness and sensitivity tests to ensure the reliability of the findings.
Consistent with previous literature, I found a statistically significant decrease in the probability of having an emergency department (ED) visit for the treatment group. While few previous studies have found an association between integrated care programs and reduced hospitalizations, I found a statistically significant decrease in the probability of inpatient hospital admission for the intervention group. Both outcome measures of healthcare services show long-term effects, with additional reductions at 12- and 24-months. Additionally, while the current literature on the impact of integrated care programs on healthcare spending is limited and varied, I found a statistically significant immediate increase in PMPM Kansas Medicaid spending followed by a decrease after 12- and 24-months post-implementation. This research contributes to our understanding of how integrated care programs impact health services utilization and costs, and it provides the first formal evaluation of the KHH program.
Description
Date
2024-01-01
Journal Title
Journal ISSN
Volume Title
Publisher
University of Kansas
Collections
Archive Status
This item contains archived web content.
Files
Sand_ku_0099D_19607.pdf
Adobe PDF, 1.5 MB
- Embargoed until 2174-05-31
Research Projects
Organizational Units
Journal Issue
Keywords
Public policy, Health care management, Mental health, Health Policy, Integrated Care, Medicaid, Mental Health