Acute-Care Utilization and Cost Offsets Associated With Language-Concordant, Pharmacist-Integrated Care Management...

Area of Science:

• Health Services Research
• Pharmacoeconomics
• Health Equity

Background:

• Safety-net clinics serve vulnerable populations with complex health needs.
• Effective care management programs are crucial for improving outcomes and controlling costs in these settings.
• Language concordance and integrated care models show promise for enhancing patient engagement and effectiveness.

Purpose of the Study:

• To evaluate the utilization and economic impact of a language-concordant, pharmacist-integrated care-management program.
• To assess the program's effectiveness and equity across different language groups and insurance statuses.

Main Methods:

• Retrospective cohort study emulating a target trial in Phoenix safety-net clinics (March 2022-September 2023).
• Utilized inverse probability weighting and doubly robust Poisson difference-in-differences analysis.
• Linked electronic health records, claims data, HIE alerts, and pharmacist logs for 526 high-need, high-cost adults.

Main Results:

• Reduced hospital admissions (IRR, 0.50) and emergency department visits (IRR, 0.47) within 60 days.
• Estimated net savings of $6421 per enrollee with a 13.66:1 return on investment.
• Similar positive trends observed in the Spanish-preferring subgroup, with no statistically significant interaction effects.

Conclusions:

• The language-concordant, pharmacist-integrated program effectively reduced short-term hospital use in safety-net settings.
• The program demonstrated substantial near-term cost offsets, indicating economic viability.
• Findings support the integration of pharmacist-led, language-concordant care management for high-need populations.