The American journal of managed care
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Randomized Controlled Trial Pragmatic Clinical Trial
Scaling care coordination through digital engagement: stepped-wedge trial assessing readmissions.
Transitions of care are pivotal, vulnerable times as patients are discharged from the hospital. Telephonic care coordination is standard care, but labor intensive. We implemented a patient postdischarge digital engagement (PDDE) program to scale coordination. We hypothesized that PDDE could reduce readmissions for low-risk patients and supplement care coordination for medium- and high-risk patients. ⋯ Our study expanded resource-limited care coordination by offering low-risk patients a service they were unable to receive previously while having no impact on readmission. PDDE efficiently provided additional touch points between patients and providers.
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Counseling and education on Medicare coverage options are available through the federal State Health Insurance Assistance Program (SHIP), but little is known about the population that SHIP reaches. ⋯ These results suggest that there are areas where in-person SHIP service expansion or other additional navigation support may be warranted.
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The near-universal access to Medicare coverage at age 65 years improves access to care. However, little is known about whether Medicare eligibility promotes the diagnosis of chronic diseases. We examined the effects of Medicare eligibility at age 65 years on the diagnosis of chronic conditions. ⋯ Our findings suggest that Medicare coverage did not necessarily lead to increased diagnosis of chronic conditions. Further research is necessary to explore the underlying mechanisms behind this observation.