Reducing Emergency Department Visits among Dual Eligible Patients via a Comprehensive Wellness Assessment

Academic Article


  • The objective was to assess whether a Comprehensive Wellness Assessment (CWA) is associated with reduced emergency department (ED) visits for Special Needs Program (SNP) enrollees with diabetes. This retrospective panel study used a Medicare Advantage plan's administrative claims data for 2010-2017 and pooled member-month observations. Multivariate regression and individual fixed-effects regression models were estimated. The outcome was ED visits measured as binary and continuous outcomes. Data were derived from claims data that included at least 1 ICD-9 or 10 code between January 2010 and December 2017. Regression results indicated that SNP enrollees completing a CWA was associated with a lower probability of any monthly ED use (β = -0.005, t-stat = -2.98) and fewer monthly visits (β = -0.008, t-stat = -2.95). Individual fixed-effects models also demonstrated a significant decline in SNP ED use after a CWA, though the strongest effects were confined to the first 4 months after a CWA. Care models with components such as CWAs may contribute an additional benefit in the form of a reduction in ED utilization. Completing a CWA appears to be effective in reducing ED utilization among SNP members with diabetes.
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    Digital Object Identifier (doi)

    Author List

  • Guerard B; Omachonu V; Sen B
  • Start Page

  • 415
  • End Page

  • 421
  • Volume

  • 22
  • Issue

  • 5