A comparison of care management delivery models on the trajectories of medical costs among patients with chronic diseases: 4-year follow-up results

In this study, we modeled the unknown form of the time-varying program effects using a spline-based technique in the Bayesian framework, where the number and locations of knots were treated unknown and learned via reversible jump Markov chain Monte Carlo. We also addressed additional modeling challenges from features seen in our healthcare cost data such as highly right-skewed outcomes with non-constant variances and extra zeros. To provide a more robust analysis, we incorporated a follow-up period of up to 4  years that is longer than the most of the published studies on care management. The results of this work demonstrate that cost savings do accrue with specific models of care management. In particular, the embedded model of care management was significantly more effective than the health plan provi ded care management in controlling medical costs after 2 years of engagement, and the savings increased over time. This information should help policy makers and employer groups achieve a better understanding of the potential value of care management.

Source: Health Services and Outcomes Research Methodology - September 8, 2016 Category: Statistics Source Type: research