Transforming Health Care Through Evidence and Collaboration
Transforming Health Care Through Evidence and Collaboration
The NIHCM Foundation is a nonprofit, nonpartisan organization dedicated to improving the effectiveness, efficiency and quality of America's health care system.
  • Data Insights

    Mental illness has become more common over the last decade, particularly among 18-25 year-olds. This Data Insights looks at trends in mental health and their implications for the future.

    Learn More
  • Briefing

    NIHCM Foundation led a briefing on Capitol Hill to discuss social determinants of health and the opioid crisis with Founding President and CEO Nancy Chockley, former CMS Administrator Don Berwick, Curtis Barnett of Arkansas Blue Cross Blue Shield, Craig Samitt of Blue Cross and Blue Shield of Minnesota, and Grant Baldwin from the CDC.

    Press Release Watch the Video
  • Data Insights

    As urbanization increases, an older, sicker and poorer population remains in rural America. Despite the health care challenges posed by these changes, promising initiatives can improve rural health.

    Learn More
  • Advisory Board

    NIHCM Foundation is pleased to welcome Dr. Scott Gottlieb, Sherry Glied, PhD, and Katherine Baicker, PhD, to its distinguished Advisory Board. Their ideas and insights will advance NIHCM's mission to improve health care for millions of Americans.

    Press Release Advisory Board
  • Awards

    NIHCM Foundation hosted the 25th Annual NIHCM Awards at the Organization of American States in Washington, D.C. to recognize outstanding health care research and journalism.

    Press Release Winners Finalists
  • News

    NIHCM welcomed Secretary Azar to a meeting in March to discuss efforts by the Department of Health and Human Services to transform health care by lowering costs and improving value for patients.

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

Events

November 13, 2019
Rural-Health-Webinar-Graphic

This webinar explored how leaders are leveraging the unique strengths of rural communities to develop and implement promising solutions.

November 18, 2019
alliance-image-111819

Part of the Beyond the Beltway: Health Policy Webinars for Journalists series, this webinar will explore the current landscape of the long-term care delivery system.

In the News

November 2019
Population Health Spotlight
aces-in-the-news 4

Does Integrated Case Management Reduce Spending in Medicaid by Changing the Way Patients Use Health Care?

Why This Study Is Important

Many state Medicaid agencies are adopting integrated case management (ICM) as a way to address the diverse medical, social and behavioral health challenges of high-need patients. As the ACA Medicaid expansions newly extend Medicaid coverage to nonelderly adults, it is important to understand how ICM affects health care service use and spending by this population and to identify ICM models that yield the greatest benefits. This study examined the impact of two different ICM models implemented during the 2009-2013 study period; the first model was largely standardized and automated while the second was much more patient-centered and interactive.

What This Study Found

  • More intense involvement with a patient-centered ICM model that utilized personalized goal setting by patients and direct one-on-one contact with the case manager significantly decreased use of ED visits, non-emergent ED care and primary care visits among participants classified as high risk. Effects on inpatient and specialty use and on total spending were also negative for this population but not statistically significant.
  • Conversely, more intense involvement with the patient-centered ICM model significantly reduced total spending for lower-risk participants, but did not affect their number of health system contacts. These participants had high rates of psychiatric conditions and substance abuse. Maintaining regular contact with the health system is likely beneficial to them, while lower intensity of care during these visits generates program savings.

What These Findings Mean

  • ICM can be a successful strategy for changing health care service use and spending of nonelderly adult Medicaid enrollees.
  • Careful program targeting, strong patient engagement and frequent direct contacts between patients and case managers are important factors for a successful program.

More About This Study

Study participants were nonpregnant, nonederly adults served by the largest Medicaid HMO operating in Virginia. ICM candidates were identified based on their patterns of service use and spending and by referrals from providers, the Medicaid agency or patients themselves. Participation in the program was voluntary. The standardized ICM model used initially by the HMO was changed to the more patient-centered model midway through the study period.

Claims from up to one year prior to ICM identification were used to stratify participants into high- and lower-risk groups, and program data on the patient's number of successful program contacts relative to time enrolled in the program were used to quantify intensity of ICM participation. Linear regression models examined pre- and post-program changes in health care use and spending as a function of the type and intensity of ICM program involvement, patient demographics including severity risk score and indicators of high use and/or spending in the pre-ICM period, and fixed effects for individual case managers.

Full Citation

Sabik LM, Bazzoli GJ, Carcaise-Edinboro P, Chandan P, and Harpe SE. “The Impact of Integrated Case Management on Health Services Use and Spending Among Nonelderly Adult Medicaid Enrollees.” Medical Care, 54(8):758-64, August 2016.

For more information about this study, contact Dr. Lindsay Sabik at lsabik[at]vcu.edu.
For more information about the NIHCM Foundation Investigator-Initiated Research Grant Program, contact Dr. Julie Schoenman at 202-296-4426.

Read More

With Medicaid expanding to cover more low-income adults, some Medicaid programs are experimenting with integrated case management (ICM) to help these patients address their specific medical, social and behavioral needs. A study led by Gloria Bazzoli and supported by a NIHCM research grant finds that ICM can decrease health service use by high-risk patients and lower spending for low-risk patients. This one-page Research Insights reviews the key takeaways from the published Medical Care article.

Events

November 13, 2019
Rural-Health-Webinar-Graphic

This webinar explored how leaders are leveraging the unique strengths of rural communities to develop and implement promising solutions.

November 18, 2019
alliance-image-111819

Part of the Beyond the Beltway: Health Policy Webinars for Journalists series, this webinar will explore the current landscape of the long-term care delivery system.

In the News

November 2019
Population Health Spotlight
aces-in-the-news 4

Grants

Journalism GrantsJournalism Grant Program

We are no longer accepting letters of inquiry for the 2019-2020 round of grantmaking. NIHCM will notify grant winners in November 2019.

Read More


NYTUpshotLogo

Investigator-Initiated Research Grant Program

We are no longer accepting letters of inquiry for the 2019-2020 round of grantmaking. A small number of applicants will be invited to submit a full proposal in September.

Read More

Awards

Winners Named in the 25th Annual Research and Journalism Awards

Winners Announcment 2018 1

Congratulations to all of the winners of the 25th Annual NIHCM Foundation Research and Journalism Awards! The winners and finalists were honored at a banquet in Washington, DC, in May.

Read More