UCLA
A Pragmatic Nationwide RCT of Coordinated Medical, Behavioral, and Social Services to Improve Care and Utilization among High-Cost, High-Need Insured Patients with Diabetes
University of California, Los Angeles and UnitedHealthcare (UHC) are partnering to evaluate a national care coordination program for high-cost, high-need commercially-insured UHC members. This care coordination program was launched in 2015 and aims to provide “whole-person care,” integrating intensive medical, behavioral and social support at a community level to address access barriers in addition to social determinants of health including food and housing insecurity. UHC designed and instituted a patient-level, pragmatic randomized controlled trial (RCT) of this program and has randomized over 500,000 individuals to either the national care coordination program or usual care. This study will analyze the effects of this program on multiple outcomes using an intention-to-treat RCT analysis as well as an instrumental variable analysis with randomization status as the instrumental variable. These analyses will evaluate whether the program is associated with reductions in diabetes complications, acute care utilization, and costs of care.
At UCLA we are excited to continue our long time collaboration with United Heathcare to gain a better understanding of how benefit design and innovative natural experiments such as the National Care Coordination Program implemented at the health plan level influence the quality, outcomes and costs of care for some of the most vulnerable persons with diabetes and other chronic conditions. The methodologic expertise and input from across the NEXT-D3 network have been invaluable as our team refines our analysis plan to best address the study questions.
- Dr. Carol M. Mangione, MD, MSPH, FACP, Dr. O. Kenrik Duru, MD, MSHS, Co-Principal Investigators of UCLA Team