Non-face-to-face care management and service utilization in patients with diabetes. Article

Full Text via DOI: 10.37765/ajmc.2023.89407 PMID: 37616148

Cited authors

  • Stoecker, Nauman, Bazzano, Price-Haywood, Yoshida, Shi

Abstract

  • OBJECTIVES\nSTUDY DESIGN\nMETHODS\nRESULTS\nCONCLUSIONS\nIn 2015, CMS implemented reimbursement for non-face-to-face chronic care management (NFFCCM) for beneficiaries with multiple chronic conditions, including diabetes. This analysis estimated the association between NFFCCM and utilization of inpatient, outpatient, and emergency services.\nWe implemented a doubly robust estimator using propensity score matching in a regression context to compare eligible patients who used NFFCCM (n = 282) with eligible patients who did not use NFFCCM (n = 26,759).\nWe tested 4 definitions of treatment: having any NFFCCM encounters and having 1 NFFCCM encounter per month, per 2 months, and per 3 months. Two-tailed statistical inference testing was conducted at the 5% level. We examined the utilization differences among patients with diabetes 65 years and older using merged electronic health records for 4 health systems in Louisiana from the Research Action for Health Network database in 2013 through 2018.\nWe found NFFCCM was associated with increased utilization of care in the outpatient setting by 0.056 visits per month (95% CI, 0.027-0.086) and with lower utilization in the inpatient setting (-0.024 visits per month; 95% CI, -0.038 to -0.010) and in the emergency department setting (-0.017 visits per month; 95% CI, -0.031 to -0.003). Alternative specifications of treatment showed similar associations.\nCMS implementation of reimbursement codes for NFFCCM, and subsequent utilization of that reimbursement by health systems, was associated with a shift in patient utilization from high-cost settings (inpatient and emergency department) to a lower-cost setting (outpatient office).

Authors

Publication date

  • 2023

Published in

International Standard Serial Number (ISSN)

  • 1088-0224

Start page

  • 417

End page

  • 422

Volume

  • 29

Issue

  • 8