Journal article

The Camden Coalition care management program improved intermediate care coordination: A randomized controlled trial

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This study was conducted by researchers at the Abdul Latif Jameel Poverty Action Lab (J-PAL) at MIT in partnership with Rutgers Center for State Health Policy and the Camden Coalition research team and published in Health Affairs. It presents results from a new analysis of the data collected from 2014 to 2017 as part of a randomized controlled trial (RCT) of our Camden Core Model. Initial RCT findings were published in 2020 in the New England Journal of Medicine.

This new analysis linked participant records with Medicaid records to determine the broader healthcare utilization impacts — including primary and specialty outpatient care, inpatient hospitalizations, emergency department (ED) use, durable medical equipment, and pharmacy use — of participation in the Camden Core Model.

The analysis found that the Camden Core Model increased outpatient visits (primary and specialty) by 15 percentage points after 14 days post discharge, a 56.5% increase relative to the control mean. These effects persisted through a full year post discharge. These findings highlight the alarming status quo in Camden at the time that the data were collected: 30% of control group patients had no primary care visits at all in the year following their hospital discharge.

The Camden Core Model also increased the proportion of individuals who had received any durable medical equipment 180 days after discharge by 12.4 percentage points, a 42% increase relative to the control mean.

As in the original RCT study, no statistically significant difference was found in hospital readmissions between the control and intervention groups. This analysis also found no significant difference in ED or pharmacy use.

The authors conclude that the Camden Core Model had important effects on intermediate care coordination goals like connection to outpatient care.

Two previous studies that also analyzed the RCT data indicate a relationship between hospital readmission rates and a) the “dosage” of staff time received by participants, as well as b) enrolled individuals’ likelihood of engaging in the program.

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