The Impact of a Specialized Condition Management Program on Emergency Department Visits in Patients with Inflammatory...

Inflammatory bowel disease (IBD) burdens patients and healthcare systems, often due to frequent emergency department (ED) visits. Comprehensive programs that connect members to providers with disease-specific expertise may improve IBD management and reduce emergency care needs.

This study evaluates the impact of a virtual condition management program on ED utilization among commercially insured members with IBD using claims data from 2017 to 2024. Propensity scores were estimated, with inverse probability of treatment weighting applied to balance baseline covariates (i.e., age, sex, prior healthcare utilization, and Charlson Comorbidity Index [CCI] scores). Weighted negative binomial regression estimated the association between program engagement and ED visit frequency, controlling for baseline characteristics. Sensitivity analyses using weighted logistic regressions evaluated the likelihood of any, gastrointestinal (GI)-related, and non-emergent ED visits post-eligibility.

Engagement was significantly associated with reduced ED utilization. Members who chose to engage experienced a 45.7% reduction in ED visits, on average, compared to unengaged (p = 0.007). Males had significantly lower visits (p = 0.012), higher CCI scores were associated with fewer visits (p = 0.005), and prior ED use was strongly associated with visit frequency (p < 0.001). Sensitivity analyses reinforced these findings as engaged members had significantly lower odds of any (odds ratio [OR]: 0.50; p = 0.003), GI-related (OR: 0.46; p = 0.014), and non-emergent (OR: 0.41; p = 0.722) visits.

Engagement with a care management program was associated with reduced ED visitation and lower likelihoods of any, non-emergent, and GI-related visits. Virtual programs offering condition-specific expertise may improve disease management and decrease reliance on ED services for patients with chronic GI diseases.