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Improving value for underserved populations with a community-based intervention: a retrospective cohort study.

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Summary

A community-based peer support program reduced healthcare costs and improved member retention for African American Medicaid enrollees. This culturally competent intervention also enhanced access to preventative care, demonstrating value in addressing social determinants of health.

Keywords:
Closing gapsCommunity based healthHigher valueInequityLower costsMember outcomesSocial Determinants of Health

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Area of Science:

  • Health Services Research
  • Health Equity
  • Community Health Interventions

Background:

  • Healthcare inequity, driven by social determinants of health (SDOH), leads to higher costs and poorer outcomes.
  • Community-based, culturally competent interventions may improve value for Medicaid enrollees by addressing health behaviors and SDOH.
  • This study evaluates the cost and quality impact of such an intervention.

Purpose of the Study:

  • To assess the effectiveness of a community-based peer support program.
  • To determine the program's impact on clinical, utilization, and financial outcomes.
  • To evaluate cost savings and quality improvements for African American Medicaid enrollees.

Main Methods:

  • Retrospective cohort study using claims data from Detroit, MI (April 2021-April 2022).
  • Propensity score matching of 738 pairs of African American Medicaid enrollees.
  • Comparison of differences in costs, utilization, and quality metrics between peer support recipients and controls.

Main Results:

  • Peer support recipients had significantly lower per member per month costs ($115 reduction).
  • A significant increase in the Adult Access to Preventative/Ambulatory Health Services quality metric was observed (8.31%).
  • Member retention was significantly higher (3.62%) for peer support recipients; other quality metrics showed no significant difference.

Conclusions:

  • Culturally competent, community-based interventions can lower costs for Medicaid enrollees.
  • These interventions are associated with improved member retention and enhanced access to preventative care.
  • Addressing SDOH through peer support shows promise for improving healthcare value in vulnerable populations.