The use of telephonic case management to link a special-needs population with a primary care physician

Gold Choice, a Medicaid managed care organization for individuals with mental health and/or substance abuse diagnoses, uses telephonic case management to link members with primary care providers (PCPs). This study assessed the effectiveness of this approach.

The number of new members without a PCP at baseline were compared with primary care encounter data documenting first PCP visits from 2003 to 2006. Paired t tests compared the mean number of new Gold Choice members linked to primary care who received telephonic case management.

During the 4 years, 52% of new members without a PCP at baseline were linked to a provider within 12 months. Paired sample t tests comparing the mean number of members linked to a PCP from baseline to 12 months for each of the 4 years yielded statistically significant results.

More than 50% of members who indicated at baseline that they had not seen a PCP were linked to primary care during the first 12 months of their enrollment in Gold Choice, suggesting that that telephonic case management may be an effective approach to linking mentally ill and/or chemically dependent patients to primary care.