Health Care Utilization, Social Determinants of Health (SDOH)
Conditions
Keywords
social determinants of health, home visiting, Medicaid, billing, health care utilization, maternal and infant health
Brief summary
This study is designed to learn whether providing additional resources to home visiting agencies in Michigan's Maternal Infant Health Program (MIHP) help them better serve families with high levels of need for basic services. The main questions it aims to answer are: 1. Do additional resources provided to agencies help imporove participants economic stability, employment, housing, and social well-being? 2. Do additional resource help improve participants use of health care services, like postpartum visits and well-child visits? 3. Do the additional resources benefit some participants more than others? Researchers will compare partipants who are served by agencies who receive additional resources to participants who are served by agencies who do not recieve additional resources to see if the additional resources have a positive impact on participants. Participants across all agencies will take a brief survey when they are discharged from the home visiting program and researchers will collect information from billing records to learn about health care utilization.
Interventions
OTHEREnhanced Billing Opportunities
Home visiting agencies in the treatment arm were able to bill for the following additional services 1) an additional home visit; 2) a complex home visit with additional face-to-face time (30 additional minutes allowed for visits longer than 60 minutes in length); 3) care coordination (including phone calls or other activities to coordinate services that lasted more than 30 minutes); and 4) a discharge visit (billed at a higher rate than a typical visit and designed to develop a plan for transitioning the family out of MIHP services).
OTHERDischarge Visit Only
Control group agencies were able to bill for typical services and a discharge visit for families deemed "high risk" on the initial screener.
Sponsors
University of Michigan
Michigan Department of Health and Human Services
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Eligible for Medicaid * Identified as "high risk" based on responses to the Maternal Risk Identifier (MRI) or Infant Risk Identifier (IRI), administered upon enrollment.
Exclusion criteria
* Participants under the age of 18.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total MIHP visits participant had with provider | Administrative data was collected after participation in the program was completed. | A variable was created to represent the total number of MIHP visits a parent had with their provider using the Medicaid claims procedural codes. |
| Total participant prenatal visits | Administrative data was collected after participation in the program was completed. | A variable was created to represent the total number of prenatal visits the parent had after their MIHP screening based on distinct claims to Medicaid. |
| Total participant ER Visits | Administrative data was collected after participation in the program was completed. | A variable was created to represent the total number of unique ER visits a parent had during the study period after their MIHP screening date using revenue codes. The variable was set to 0 if no claims were found. |
| Participant ever had a postpartum visit | Administrative data was collected after participation in the program was completed. | A dichotomous variable was created to represent whether the parent ever had a postpartum visit claim after their MIHP screening, equal to 1 if there was a claim and service date after the infant's data of birth. The variable was set to 0 if no claims were found. |
| Total ER Visits Infant | Administrative data was collected after participation in the program was completed. | A variable was created to represent the total number of unique ER visits an infant of a participant had during the study period using revenue codes. The variable was set to 0 if no claims were found. |
| Total well child visits | Administrative data was collected after participation in the program was completed. | A variable was created to represent the total number of unique well child visits a child had during the study period using diagnosis codes and procedure codes. The variable was set to 0 if no claims were found. Any infant who did not appear in the Medicaid eligibility file or who had a date of death within a year of birth had all values related to well child visits set to missing. |
Countries
United States
Outcome results
None listed