Cross-Sector Partnerships and Emergency Department Use Among Older Adults: Evidence From Colorado's Accountable...

Area of Science:

• Health Services Research
• Public Health Policy
• Geriatric Medicine

Background:

• Health-related social needs (HRSNs) are linked to higher emergency department (ED) utilization in older adults.
• The Accountable Health Communities (AHC) Model aims to mitigate healthcare use by addressing HRSNs.
• Medicare beneficiaries are a key population targeted by the AHC Model's interventions.

Purpose of the Study:

• To evaluate the impact of the AHC Model's Alignment Track on ED visits among Medicare beneficiaries in Colorado.
• To assess the effectiveness of connecting Medicare beneficiaries to community resources for HRSNs.
• To analyze changes in healthcare utilization patterns post-AHC Model implementation.

Main Methods:

• A two-way fixed effects difference-in-differences (DiD) analysis was conducted.
• County-level claims data from the Colorado All-Payer Claims Database (2014-2019) were utilized.
• The study focused on Medicare beneficiaries and their ED visit rates.

Main Results:

• Counties participating in the AHC Alignment Track showed a reduction of approximately 26 all-cause ED visits per 1,000 people.
• A decrease of about nine preventable ED visits per 1,000 people was observed in these counties.
• The observed reductions suggest a potential positive impact of the AHC Model on ED utilization.

Conclusions:

• The AHC Model's Alignment Track may reduce ED visits among Medicare beneficiaries by addressing HRSNs.
• Pre-existing downward trends in ED visits warrant caution in attributing all observed changes solely to the AHC Model.
• Further investigation is necessary to confirm the causal relationship and understand the mechanisms through which the AHC Alignment Track influences ED use.