Medical expenses for the pediatric population have decreased in Illinois

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Researchers from the University of Illinois at Chicago are reporting Open JAMA network that Medicaid expenses for children and young adults have decreased in Illinois. However, a demonstration project of coordination of assistance has not further reduced the cost of assistance for the children participating in the program within its first year.

The project, known as CHECK, was established at UIC in 2014 to develop and test a global care coordination model for children and young adults covered by Medicaid with chronic conditions living in Chicago and their families. The study included 6,259 patients with conditions such as sickle cell anemia, asthma, diabetes, seizure disorders and prematurity.

For the study, the researchers analyzed the claims paid one year before the CHECK participants' enrollment and one year after enrollment, from 1 May 2014 to 30 April 2017. They compared the expenses and ; use of health care, including emergency room visits and hospitalizations, among patients enrolled in CHECK – 3.126 individuals – in a similarly sized control group.

They saw a reduction in use among patients enrolled in CHECK – hospital admissions decreased by 30.9% and emergency room visits by 18% – but the reduction was similar in the control group.

The average cost of care for CHECK patients dropped to $ 1,341, from $ 1,633. The reduction was almost identical in the control group patients, for whom the average cost of care dropped to $ 1.413, from $ 1.703. The difference was $ 292 and $ 290 respectively.

"Although the first year of CHECK did not affect Medicaid expenses, we know that child care coordination programs have many intangible benefits for participants and family members that could take years to fully appreciate and measure," said Dr. . Rachel Caskey, UIC associate professor of medicine and pediatrics at the College of Medicine and first author of the study.

The dott. Benjamin Van Voorhees, director of the CHECK project and senior author of the study, said the data was probably influenced by global changes in the Medicaid Illinois program during the study period.

"During the year of this study, the newly introduced Medicaid plans probably played a role in reducing healthcare costs in both groups, making the comparison between the two groups more complicated than expected," said Van Voorhees , professor and head of pediatrics.

Caskey said it may be too early to see a reduction in expenses.

"A year is probably not long enough to fully appreciate the impact of CHECK. As we continue to analyze the data, we may find further cost reductions the more children are enrolled in the program. Or, we may find that there are other benefits" Caskey said.

In addition to the cost and health benefits of the program, the CHECK program also aims to reduce school absenteeism and increase family engagement in the health care process. The data on these fronts are imminent.

Van Voorhees said the CHECK program will continue to provide coordinated assistance to a growing group of patients, including adults, covered by Medicaid.

We decided to demonstrate the feasibility of a large-scale assistance coordination model for a pediatric population and, by combining the use of community health workers and social care professionals with the technology of healthcare. ; health information, we succeeded.

We have a lot to learn from this model and, although these data are not the expected ones, they will help us perfect the program. CHECK aims to address very complex challenges in our health system by eliminating the barriers that many families encounter when it comes to accessing or taking full advantage of care. Cost is an important part of CHECK's history, but it is not its complete history. This study brings us closer to understanding where and how the coordination of care is most effective.

Dr. Benjamin Van Voorhees, chief of pediatrics at the Illinois University in Chicago

Source:

Journal reference:

Caskey, R. et al. (2019) Effect of coordinating comprehensive care on Medicaid expenses compared to the usual care between children and young people with chronic illness. Open JAMA network. doi.org/10.1001/jamanetworkopen.2019.12604

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