Case Management for Health Care Superutilizers
What You Need to Know Before You Apply
What is the purpose of this trial?
The Standard Care Coordination (SCC) solution integrates aspects of case management \& care coordination \& was designed by UnitedHealth Group for high-cost, complex, at-risk consumers to facilitate health care access and decisions that can have a dramatic impact on the quality and affordability of the consumer's health care. Currently members only receive the SCC if they are: 1) identified as high risk for readmission upon discharge from the hospital, 2) are self-referred, or 3) are directly referred to the program by their physician. The current quality improvement study was designed as a randomized controlled trial to determine if the expansion of the SCC program to commercially insured members identified via a proprietary administrative algorithms as being at high risk would significantly impact rates of acute inpatient admissions.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.
Is case management generally safe for humans?
Case management, which involves coordinating healthcare services, is generally considered safe and focuses on improving patient safety by using decision support tools and safety protocols. It is used to enhance patient outcomes and reduce hospital readmissions, indicating a focus on safety in its application.12345
How is the treatment 'Case Management for Health Care Superutilizers' different from other treatments?
What data supports the effectiveness of the treatment Community Health Worker Case Management and similar approaches?
Research shows that case management, which involves coordinating a patient's healthcare services, can improve treatment adherence and patient outcomes, especially for those with complex health issues. This approach has been effective in improving care coordination and quality of life for patients with conditions like cancer and musculoskeletal injuries.511121314
Who Is on the Research Team?
Anthony V Pirrello, MS
Principal Investigator
UnitedHealthcare
Are You a Good Fit for This Trial?
This trial is for UnitedHealthcare commercial members over 18 years old, in any state, who are at high risk of frequent hospital visits as determined by a special algorithm. It's not for pregnant women, those with 'do not contact' status, on infertility treatment or part of certain health plans like ACOs or legacy UHC groups.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive standard care coordination and disease management, with some receiving additional case management
Follow-up
Participants are monitored for safety and effectiveness after treatment
Long-term Monitoring
Participants are monitored for various health outcomes such as emergency room visits, diabetes-related complications, and adherence to care processes
What Are the Treatments Tested in This Trial?
Interventions
- Community Health Worker Case Management
- RN case management
- RN Standard care coordination and disease management
Community Health Worker Case Management is already approved in United States for the following indications:
Find a Clinic Near You
Who Is Running the Clinical Trial?
UnitedHealthcare
Lead Sponsor
University of California, Los Angeles
Collaborator