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Managed care COVID-19 outcomes in a population health program
Richard B Aguilar, Patrick Hardigan, Bindu S Mayi
1Cano Health, 9725 NW 117 Ave, Suite 200, Miami, FL 33178.
Objectives:
To determine (1) factors linked to hospitalizations among managed care patients (MCPs), (2) outcome improvement with use of outpatient off-label treatment, and (3) outcome comparison between MCPs and a mirror group.
Study Design:
Retrospective cohort study comparing MCPs with an age- and gender-matched mirror group in Florida from April 1, 2020, to May 31, 2020.
Methods:
A total of 38,193 MCPs in a Florida primary care group were monitored for COVID-19 incidence, hospitalization, and mortality. The highest-risk patients were managed by the medical group's COVID-19 Task Force. As part of a population health program, the COVID-19 Task Force contacted patients, conducted medical encounters, and tracked data including comorbidities and medical outcomes. The MCPs enrolled in the medical group were compared with a mirror group from the state of Florida.
Results:
The mean (SD) age among the MCPs was 67.9 (15.2) years, and 60% were female. Older age and hypertension were the most important factors in predicting COVID-19. Obesity, chronic kidney disease (CKD), and congestive heart failure (CHF) were linked to higher rates of hospitalizations. Patients prescribed off-label outpatient medications had 73% lower likelihood of hospitalization (P < .05). Compared with the mirror group, MCPs had 60% lower COVID-19 mortality (P < .05).
Conclusions:
MCPs have risk factors similar to the general population for COVID-19 incidence and progression, including older age, hypertension, obesity, CHF, and CKD. Outpatient treatment with off-label medicines decreased hospitalizations. A comprehensive population health program decreased COVID-19 mortality.
Insights
Managed care patients (MCPs) with risk factors like older age and hypertension face COVID-19 hospitalization risks. Off-label outpatient treatment significantly reduced hospitalizations, and a population health program lowered COVID-19 mortality.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Managed care patients (MCPs) share risk factors with the general population for COVID-19, including older age, hypertension, obesity, chronic kidney disease (CKD), and congestive heart failure (CHF).
- Understanding factors influencing COVID-19 outcomes in MCPs is crucial for targeted interventions and resource allocation.
- The study investigates the impact of outpatient treatment and population health programs on COVID-19 outcomes within this specific patient group.
Purpose of the Study:
- To identify factors associated with COVID-19 hospitalizations among MCPs.
- To evaluate the effectiveness of off-label outpatient treatment in improving outcomes.
- To compare COVID-19 outcomes between MCPs and a matched mirror group.
Main Methods:
- A retrospective cohort study design was employed, comparing 38,193 MCPs in Florida with an age- and gender-matched mirror group.
- Data on COVID-19 incidence, hospitalization, and mortality were collected from April 1, 2020, to May 31, 2020.
- A dedicated COVID-19 Task Force managed high-risk patients, including medical encounters and outcome tracking.
Main Results:
- Older age and hypertension were key predictors of COVID-19 hospitalization. Obesity, CKD, and CHF were also linked to increased hospitalization rates.
- Patients receiving off-label outpatient medications demonstrated a 73% lower likelihood of hospitalization (P < .05).
- MCPs experienced a 60% reduction in COVID-19 mortality compared to the mirror group (P < .05).
Conclusions:
- MCPs exhibit similar COVID-19 risk factors to the general population, necessitating proactive management strategies.
- The utilization of off-label outpatient medications proved effective in reducing hospitalization rates.
- Comprehensive population health programs significantly contributed to a decrease in COVID-19 mortality among MCPs.
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