Status:

UNKNOWN

Intensive Management of At-risk Patients

Lead Sponsor:

CareMore Health, San Bernardino

Conditions:

Chronic Disease

Eligibility:

All Genders

Phase:

NA

Brief Summary

The purpose of this study is to assess if intensive management of at-risk participants, utilizing longitudinal patient tracking, proactive outreach, multidisciplinary action planning and careful outco...

Detailed Description

At-risk participants will be randomized 1:1 to either usual care or intensive management utilizing longitudinal patient tracking, proactive outreach, multidisciplinary action planning and careful outc...

Eligibility Criteria

Inclusion

  • At-risk patients, meaning Gold, Silver, or Bronze tier, as identified by our member 360 platform:
  • Gold tier - 6+ emergency department (ED) visits last year, annual spend \>$100,000, 8 or more hierarchical condition category (HCC) diagnoses, readmission \<30 days prior, or ambulatory care-sensitive condition (ACSC) hospitalization \<30 days prior
  • Silver tier - 4+ ED visits last year, annual spend \>$75,000, 6 or more HCC diagnoses, readmission \<90 days prior, substance abuse HCC diagnosis, behavioral health admit \<90 days, 15+ chronic medications prescribed in the last 90 days (and not qualifying for Gold tier)
  • Bronze tier - 3+ ED visits last year, annual spend \>$50,000, 5 or more HCC diagnoses, 3+ hospitalizations last year, end-stage liver disease, end-stage renal disease, Medicare and Medicaid dual-enrolled, disease-management program patients with ACSC admission or ED visit in the last year, 10+ chronic medications in the last 90 days, 6+ health risk-assessment score, 12+ Edmonton Frail Scale score (and not qualifying for Gold or Silver tiers)

Exclusion

  • enrolled in hospice
  • enrolled in Institutional Special Needs Plan
  • primary patient of study investigator

Key Trial Info

Start Date :

July 1 2020

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

December 31 2020

Estimated Enrollment :

600 Patients enrolled

Trial Details

Trial ID

NCT04456725

Start Date

July 1 2020

End Date

December 31 2020

Last Update

July 2 2020

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