Trial Outcomes & Findings for Care Coordination for Children With Disabilities (NCT NCT02304380)
NCT ID: NCT02304380
Last Updated: 2020-07-02
Results Overview
This outcome was measured using the validated tool, "Family Experiences with Coordination of Care" (FECC) survey. The FECC survey is made up of 20 separate and independent quality indicators related to care coordination for children with medical complexity. To be included in the denominator for this measure, caregivers first had to report that their child visited more than one doctor's office or used more than one kind of health care service in the 12 months prior to the survey date. To measure the percent of caregivers who reported that their child has a designated care coordinator among those in the denominator, caregivers needed to have answered yes to one of the following two questions: "Did anyone in the main provider's office help you to manage your child's care or treatment from different doctors or care providers?" or "Did anyone outside of the main provider's office help you to manage your child's care or treatment from different doctors or care providers?".
COMPLETED
2188 participants
12 month lookback from time of survey
2020-07-02
Participant Flow
Claims data records for 64,382 participants were analyzed to address Claims Data Analysis (Aim 3).
64,382 met eligibility criteria for inclusion in the claims data analysis which was non-human subjects research.
Participant milestones
| Measure |
Accountable Care Organization (ACO) Stakeholder Interviews
Stakeholders from the ACO, insurance payers, departments of health, and representatives from other stakeholder organizations who have knowledge of/experience with care coordination for children with disabilities before and after the 2013 policy change. Informants included leaders, staff, clinicians, representatives Medicaid managed care organizations, and representatives from public health organizations.
|
Caregiver & Youth Focus Groups
Caregivers of children with disabilities, and youth (i.e. patients) with disabilities.
To be eligible to participate, the child (as the participant, OR of the caregiver) must:
1. Have resided continuously in the region served by the ACO, have been continuously enrolled in Medicaid, and have had Medicaid Aged, Blind, or Disable (ABD) status since at least one year before the policy change;
2. Be no more than 18 years of age at the time of data collection; and
3. Have been, at the time of the policy change, at least 14 years of age for youth (patient) focus groups, or 2 years of age for caregiver focus groups.
|
Caregiver Interviews
Caregivers of children with disabilities. To be eligible to participate, the caregiver's child must: 1. Have resided continuously in the region served by the ACO, have been continuously enrolled in Medicaid, and have had Medicaid Aged, Blind, or Disabled (ABD) status since at least one year before the policy change; 2. Be no more than 18 years of age at the time of data collection; and 3. Have been, at the time of the policy change, at least 2 years of age.
|
Caregiver Survey
Caregivers of children with disabilities who are part of the ACO, and fall into one of three categories: 1) children with ABD status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-ACO Sample
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes any child who was ABD status at any point during August 2011-June 2016; dataset does not include children without ABD status. These are unique participants. They were not consented or considered "enrolled".
|
Claims Data-Control Sample
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|---|---|---|---|
|
Pediatric Claims Data Analysis (Aim 3)
STARTED
|
0
|
0
|
0
|
0
|
17356
|
47026
|
|
Pediatric Claims Data Analysis (Aim 3)
COMPLETED
|
0
|
0
|
0
|
0
|
17356
|
47026
|
|
Pediatric Claims Data Analysis (Aim 3)
NOT COMPLETED
|
0
|
0
|
0
|
0
|
0
|
0
|
|
Pediatric Adult Caregiver Survey (Aim 2)
STARTED
|
0
|
0
|
0
|
2096
|
0
|
0
|
|
Pediatric Adult Caregiver Survey (Aim 2)
COMPLETED
|
0
|
0
|
0
|
2062
|
0
|
0
|
|
Pediatric Adult Caregiver Survey (Aim 2)
NOT COMPLETED
|
0
|
0
|
0
|
34
|
0
|
0
|
|
Interviews & Focus Groups (Aim 1)
STARTED
|
0
|
35
|
33
|
0
|
0
|
0
|
|
Interviews & Focus Groups (Aim 1)
COMPLETED
|
0
|
35
|
33
|
0
|
0
|
0
|
|
Interviews & Focus Groups (Aim 1)
NOT COMPLETED
|
0
|
0
|
0
|
0
|
0
|
0
|
|
ACO Stakeholder Interviews (Aim 1)
STARTED
|
24
|
0
|
0
|
0
|
0
|
0
|
|
ACO Stakeholder Interviews (Aim 1)
COMPLETED
|
24
|
0
|
0
|
0
|
0
|
0
|
|
ACO Stakeholder Interviews (Aim 1)
NOT COMPLETED
|
0
|
0
|
0
|
0
|
0
|
0
|
Reasons for withdrawal
| Measure |
Accountable Care Organization (ACO) Stakeholder Interviews
Stakeholders from the ACO, insurance payers, departments of health, and representatives from other stakeholder organizations who have knowledge of/experience with care coordination for children with disabilities before and after the 2013 policy change. Informants included leaders, staff, clinicians, representatives Medicaid managed care organizations, and representatives from public health organizations.
|
Caregiver & Youth Focus Groups
Caregivers of children with disabilities, and youth (i.e. patients) with disabilities.
To be eligible to participate, the child (as the participant, OR of the caregiver) must:
1. Have resided continuously in the region served by the ACO, have been continuously enrolled in Medicaid, and have had Medicaid Aged, Blind, or Disable (ABD) status since at least one year before the policy change;
2. Be no more than 18 years of age at the time of data collection; and
3. Have been, at the time of the policy change, at least 14 years of age for youth (patient) focus groups, or 2 years of age for caregiver focus groups.
|
Caregiver Interviews
Caregivers of children with disabilities. To be eligible to participate, the caregiver's child must: 1. Have resided continuously in the region served by the ACO, have been continuously enrolled in Medicaid, and have had Medicaid Aged, Blind, or Disabled (ABD) status since at least one year before the policy change; 2. Be no more than 18 years of age at the time of data collection; and 3. Have been, at the time of the policy change, at least 2 years of age.
|
Caregiver Survey
Caregivers of children with disabilities who are part of the ACO, and fall into one of three categories: 1) children with ABD status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-ACO Sample
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes any child who was ABD status at any point during August 2011-June 2016; dataset does not include children without ABD status. These are unique participants. They were not consented or considered "enrolled".
|
Claims Data-Control Sample
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|---|---|---|---|
|
Pediatric Adult Caregiver Survey (Aim 2)
Withdrawal by Subject
|
0
|
0
|
0
|
34
|
0
|
0
|
Baseline Characteristics
Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
Baseline characteristics by cohort
| Measure |
ACO Stakeholder Interviews
n=24 Participants
Stakeholders from the ACO, insurance payers, departments of health, and representatives from other stakeholder organizations who have knowledge of/experience with care coordination for children with disabilities before and after the 2013 policy change. Informants included leaders, staff, clinicians, representatives Medicaid managed care organizations, and representatives from public health organizations.
|
Caregiver & Youth Focus Groups
n=35 Participants
Caregivers of children with disabilities, and youth (i.e. patients) with disabilities.
To be eligible to participate, the child (as the participant, OR of the caregiver) must:
1. Have resided continuously in the region served by the ACO, have been continuously enrolled in Medicaid, and have had Medicaid Aged, Blind, or Disable (ABD) status since at least one year before the policy change;
2. Be no more than 18 years of age at the time of data collection; and
3. Have been, at the time of the policy change, at least 14 years of age for youth (patient) focus groups, or 2 years of age for caregiver focus groups.
|
Caregiver Interviews
n=33 Participants
Caregivers of children with disabilities. To be eligible to participate, the caregiver's child must: 1. Have resided continuously in the region served by the ACO, have been continuously enrolled in Medicaid, and have had Medicaid Aged, Blind, or Disabled (ABD) status since at least one year before the policy change; 2. Be no more than 18 years of age at the time of data collection; and 3. Have been, at the time of the policy change, at least 2 years of age.
|
Caregiver Survey
n=2062 Participants
Caregivers of children with disabilities who are part of the ACO, and fall into one of three categories: 1) children with ABD status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-ACO Sample
n=17356 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes any child who was ABD status at any point during August 2011-June 2016; dataset does not include children without ABD status. These are unique participants. They were not consented or considered "enrolled".
|
Claims Data-Control Sample
n=47026 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
Total
n=66536 Participants
Total of all reporting groups
|
|---|---|---|---|---|---|---|---|
|
Age, Categorical
<=18 years
|
—
|
2 Participants
n=34 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
0 Participants
n=33 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
0 Participants
n=2057 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
17356 Participants
n=17356 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
47026 Participants
n=47026 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
64384 Participants
n=66506 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
|
Age, Categorical
Between 18 and 65 years
|
—
|
31 Participants
n=34 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
33 Participants
n=33 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
2019 Participants
n=2057 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
0 Participants
n=17356 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
0 Participants
n=47026 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
2083 Participants
n=66506 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
|
Age, Categorical
>=65 years
|
—
|
1 Participants
n=34 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
0 Participants
n=33 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
38 Participants
n=2057 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
0 Participants
n=17356 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
0 Participants
n=47026 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
39 Participants
n=66506 Participants • Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey. No data were collected for the ACO stakeholder arm/groups.
|
|
Age, Continuous
|
—
|
38.6 years
n=34 Participants • Demographic data for ACO Stakeholder Interviews were not collected. Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey.
|
40 years
n=33 Participants • Demographic data for ACO Stakeholder Interviews were not collected. Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey.
|
—
|
12.3 years
n=17356 Participants • Demographic data for ACO Stakeholder Interviews were not collected. Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey.
|
12.7 years
n=47026 Participants • Demographic data for ACO Stakeholder Interviews were not collected. Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey.
|
12.6 years
n=64449 Participants • Demographic data for ACO Stakeholder Interviews were not collected. Age was missing for 1 person from the focus groups. Age was missing for 5 persons from the caregiver survey.
|
|
Sex: Female, Male
Female
|
—
|
33 Participants
n=35 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061. Did not collect demographic data for the ACO stakeholder interview arm/group.
|
32 Participants
n=33 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061. Did not collect demographic data for the ACO stakeholder interview arm/group.
|
1908 Participants
n=2061 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061. Did not collect demographic data for the ACO stakeholder interview arm/group.
|
5901 Participants
n=17356 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061. Did not collect demographic data for the ACO stakeholder interview arm/group.
|
16224 Participants
n=47026 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061. Did not collect demographic data for the ACO stakeholder interview arm/group.
|
24098 Participants
n=66511 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061. Did not collect demographic data for the ACO stakeholder interview arm/group.
|
|
Sex: Female, Male
Male
|
—
|
2 Participants
n=35 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061. Did not collect demographic data for the ACO stakeholder interview arm/group.
|
1 Participants
n=33 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061. Did not collect demographic data for the ACO stakeholder interview arm/group.
|
153 Participants
n=2061 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061. Did not collect demographic data for the ACO stakeholder interview arm/group.
|
11455 Participants
n=17356 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061. Did not collect demographic data for the ACO stakeholder interview arm/group.
|
30802 Participants
n=47026 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061. Did not collect demographic data for the ACO stakeholder interview arm/group.
|
42413 Participants
n=66511 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061. Did not collect demographic data for the ACO stakeholder interview arm/group.
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
—
|
0 Participants
n=35 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
0 Participants
n=33 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
76 Participants
n=2061 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
0 Participants
n=17356 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
0 Participants
n=47026 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
76 Participants
n=66511 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
—
|
35 Participants
n=35 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
30 Participants
n=33 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
1981 Participants
n=2061 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
0 Participants
n=17356 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
0 Participants
n=47026 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
2046 Participants
n=66511 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
—
|
0 Participants
n=35 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
3 Participants
n=33 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
4 Participants
n=2061 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
17356 Participants
n=17356 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
47026 Participants
n=47026 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
64389 Participants
n=66511 Participants • We did not collect demographic data on our key informants. Ethnicity data are not available for the Claims Data-ACO Sample/Claims Data Control Sample.
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
—
|
0 Participants
n=35 Participants • We did not collect demographic data on our key informants.
|
0 Participants
n=33 Participants • We did not collect demographic data on our key informants.
|
10 Participants
n=2061 Participants • We did not collect demographic data on our key informants.
|
29 Participants
n=17356 Participants • We did not collect demographic data on our key informants.
|
68 Participants
n=47026 Participants • We did not collect demographic data on our key informants.
|
107 Participants
n=66511 Participants • We did not collect demographic data on our key informants.
|
|
Race (NIH/OMB)
Asian
|
—
|
0 Participants
n=35 Participants • We did not collect demographic data on our key informants.
|
0 Participants
n=33 Participants • We did not collect demographic data on our key informants.
|
10 Participants
n=2061 Participants • We did not collect demographic data on our key informants.
|
141 Participants
n=17356 Participants • We did not collect demographic data on our key informants.
|
209 Participants
n=47026 Participants • We did not collect demographic data on our key informants.
|
360 Participants
n=66511 Participants • We did not collect demographic data on our key informants.
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
—
|
0 Participants
n=35 Participants • We did not collect demographic data on our key informants.
|
0 Participants
n=33 Participants • We did not collect demographic data on our key informants.
|
2 Participants
n=2061 Participants • We did not collect demographic data on our key informants.
|
4 Participants
n=17356 Participants • We did not collect demographic data on our key informants.
|
57 Participants
n=47026 Participants • We did not collect demographic data on our key informants.
|
63 Participants
n=66511 Participants • We did not collect demographic data on our key informants.
|
|
Race (NIH/OMB)
Black or African American
|
—
|
12 Participants
n=35 Participants • We did not collect demographic data on our key informants.
|
13 Participants
n=33 Participants • We did not collect demographic data on our key informants.
|
628 Participants
n=2061 Participants • We did not collect demographic data on our key informants.
|
5102 Participants
n=17356 Participants • We did not collect demographic data on our key informants.
|
21633 Participants
n=47026 Participants • We did not collect demographic data on our key informants.
|
27388 Participants
n=66511 Participants • We did not collect demographic data on our key informants.
|
|
Race (NIH/OMB)
White
|
—
|
23 Participants
n=35 Participants • We did not collect demographic data on our key informants.
|
20 Participants
n=33 Participants • We did not collect demographic data on our key informants.
|
1265 Participants
n=2061 Participants • We did not collect demographic data on our key informants.
|
11306 Participants
n=17356 Participants • We did not collect demographic data on our key informants.
|
23030 Participants
n=47026 Participants • We did not collect demographic data on our key informants.
|
35644 Participants
n=66511 Participants • We did not collect demographic data on our key informants.
|
|
Race (NIH/OMB)
More than one race
|
—
|
0 Participants
n=35 Participants • We did not collect demographic data on our key informants.
|
0 Participants
n=33 Participants • We did not collect demographic data on our key informants.
|
67 Participants
n=2061 Participants • We did not collect demographic data on our key informants.
|
0 Participants
n=17356 Participants • We did not collect demographic data on our key informants.
|
0 Participants
n=47026 Participants • We did not collect demographic data on our key informants.
|
67 Participants
n=66511 Participants • We did not collect demographic data on our key informants.
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
—
|
0 Participants
n=35 Participants • We did not collect demographic data on our key informants.
|
0 Participants
n=33 Participants • We did not collect demographic data on our key informants.
|
79 Participants
n=2061 Participants • We did not collect demographic data on our key informants.
|
774 Participants
n=17356 Participants • We did not collect demographic data on our key informants.
|
2029 Participants
n=47026 Participants • We did not collect demographic data on our key informants.
|
2882 Participants
n=66511 Participants • We did not collect demographic data on our key informants.
|
|
Region of Enrollment
United States
|
24 Participants
n=24 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061.
|
35 Participants
n=35 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061.
|
33 Participants
n=33 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061.
|
2061 Participants
n=2061 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061.
|
17356 Participants
n=17356 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061.
|
47026 Participants
n=47026 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061.
|
66535 Participants
n=66535 Participants • We collected 2062 caregiver surveys. For the analyses, we dropped one survey because the participant's demographic data on the caregiver survey did not match medical record data. Because we dropped one survey, the final sample size for analysis was 2061.
|
PRIMARY outcome
Timeframe: 12 month lookback from time of surveyPopulation: To be included in the analysis for this measure, caregivers first had to report that their child visited more than one doctor's office or used more than one kind of health care service in the 12 months prior to the survey date.
This outcome was measured using the validated tool, "Family Experiences with Coordination of Care" (FECC) survey. The FECC survey is made up of 20 separate and independent quality indicators related to care coordination for children with medical complexity. To be included in the denominator for this measure, caregivers first had to report that their child visited more than one doctor's office or used more than one kind of health care service in the 12 months prior to the survey date. To measure the percent of caregivers who reported that their child has a designated care coordinator among those in the denominator, caregivers needed to have answered yes to one of the following two questions: "Did anyone in the main provider's office help you to manage your child's care or treatment from different doctors or care providers?" or "Did anyone outside of the main provider's office help you to manage your child's care or treatment from different doctors or care providers?".
Outcome measures
| Measure |
Caregiver Survey
n=1201 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Percent of Caregivers Who Reported That Their Child Has a Designated Care Coordinator
|
864 Participants
|
—
|
SECONDARY outcome
Timeframe: 3 month lookback from time of surveyPopulation: Percentage of participants who reported that their child visited more than one doctor's office or used more than one kind of health care service in the last 12 months and who were contacted by their care coordinator in the past 3 months
This outcome was measured using FECC survey. To be included in the denominator for this measure, caregivers first had to report that their child visited more than one doctor's office or used more than one kind of health care service in the 12 months prior to the survey date AND were contacted by their care coordinator in the past 3 months. Caregivers then had to respond positively to both of the following two questions: "In the last 3 months, when the person who helped you with managing your child's care contacted you, how often did he or she ask if you had any concerns about your child's health or treatment?" and "In the last 3 months, when the person who helped you with managing your child's care contacted you, how often did he or she ask if your child's health had changed in any way?".
Outcome measures
| Measure |
Caregiver Survey
n=435 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Percent of Caregivers Who Reported That Their Care Coordinator Asked About Caregiver Concerns and Changes in the Child's Health
|
261 Participants
|
—
|
SECONDARY outcome
Timeframe: 12 month lookback from time of surveyPopulation: To be included in the analysis for this measure, caregivers first had to report that they received a written after visit summary in the past 12 months
This outcome was measured using FECC survey. To be included in the denominator for this measure, caregivers first had to report that they received a written after-visit summary from their child's main provider's office. Caregivers then had to report that the written after-visit summary contained all of the following elements: current problem list, current medication list, drug allergies, specialists involved in the child's care, planned follow-up, and what to do for problems related to the outpatient visit.
Outcome measures
| Measure |
Caregiver Survey
n=1259 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Percent of Caregivers Who Reported Receiving a Comprehensive Written After-visit Summary in the Past 12 Months
|
523 Participants
|
—
|
SECONDARY outcome
Timeframe: 12 month lookback from time of surveyPopulation: Participants who responded to the question, "Has the main provider created a shared care plan for your child?"
This outcome was measured using FECC survey. Caregivers needed to have answered yes to the following question: "Has the main provider created a shared care plan for your child?".
Outcome measures
| Measure |
Caregiver Survey
n=1983 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Percent of Caregivers Who Reported That Their Child's Primary Care Provider Created a Shared Care Plan for Their Child
|
985 Participants
|
—
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: The overall data included children up to 18 years of age; however, only those children less than or equal to 6 years of age were included in the analysis.
Indicator of use of an age-appropriate well-child visit for children less than or equal to 6 years of age according to the Healthcare Effectiveness Data and Information Set (HEDIS) due to the Accountable Care Organization (ACO). ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of visits in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=4 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=11 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Use of One or More Well-child Visits <=6 Years Old
|
9,235 person-year observations
|
25,106 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Patients who are greater than or equal to 12 years of age
Use of an age-appropriate well-child visits for children greater than or equal to 12 years of age according to the Healthcare Effectiveness Data and Information Set (HEDIS) due to the ACO. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of visits in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=10 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=29 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Use of One or More Well-child Visits >=12 Years Old
|
24,342 person-year observations
|
72,803 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Please note that the number of person-year observations is the same for multiple outcomes - as long as a child is enrolled in Medicaid that year, we would have the same number of observations.
An indicator of one or more outpatient visits to primary care providers (PCP). ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of visits in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=17 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=47 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Indicator of Use of Primary Care
|
49,358 person-year observations
|
142,579 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Please note that the number of person-year observations is the same for multiple outcomes - as long as a child is enrolled in Medicaid that year, we would have the same number of observations.
Use of one or more outpatient visits to other mental health specialists besides psychiatrists. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of visits in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=17 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=47 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Use of Outpatient Medicaid Visits to Other Behavioral Health Providers
|
49,358 person-year observations
|
142,579 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Please note that the number of person-year observations is the same for multiple outcomes - as long as a child is enrolled in Medicaid that year, we would have the same number of observations.
Indicator of utilization of emergency department. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of visits in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=17 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=47 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Emergency Department Use
|
49,358 person-year observations
|
142,579 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Please note that the number of person-year observations is the same for multiple outcomes - as long as a child is enrolled in Medicaid that year, we would have the same number of observations.
Indicator of hospitalization for patients. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of visits in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=17 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=47 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Use of Hospitalizations
|
49,358 person-year observations
|
142,579 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 30 months postPopulation: Children who were hospitalized
Indicator of follow-up within 7 days after hospitalization. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of visits in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=3 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=11 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Follow-up Within 7 Days After Hospitalization
|
10,602 person-year observations
|
31,968 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Children who were hospitalized
Indicator of having follow-up within 30 days after hospitalization. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of visits in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=3 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=11 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Follow-up Within 30 Days After Hospitalization
|
10,602 person-year observations
|
31,968 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Children who were hospitalized
Indicator of hospital readmissions within 30 days after discharge. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control group include any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of readmissions in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=3 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=11 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Hospital Readmissions Within 30 Days After Discharge
|
10,602 person-year observations
|
31,968 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Children hospitalized for mental illness. Please note that the number of person-year observations is the same for multiple outcomes - as long as a child is enrolled in Medicaid that year, we would have the same number of observations.
Indicator of hospitalization for mental illness for patients. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of visits in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=17 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=47 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Hospitalization for Mental Illness
|
49,358 person-year observations
|
142,579 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Children hospitalized for mental illness
Indicator of follow-up within 7 days after hospitalization for mental illness. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of visits in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=818 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=3 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Follow-up Within 7 Days After Hospitalization for Mental Illness
|
1,484 person-year observations
|
7,409 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Children who were hospitalized for mental illness
Indicator of follow-up within 30 days after hospitalization for mental illness. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of visits in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=818 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=3 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Follow-up Within 30 Days After Hospitalization for Mental Illness
|
1,484 person-year observations
|
7,409 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Please note that the number of person-year observations is the same for multiple outcomes - as long as a child is enrolled in Medicaid that year, we would have the same number of observations.
Indicator of antidepressant medication fills. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of medication fills in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=17 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=47 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Medication Use - Antidepressants
|
49,358 person-year observations
|
142,579 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Please note that the number of person-year observations is the same for multiple outcomes - as long as a child is enrolled in Medicaid that year, we would have the same number of observations.
Indicator of use of anticonvulsant medication fills. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of medication fills in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=17 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=47 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Medication Use - Anticonvulsants
|
49,358 person-year observations
|
142,579 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Please note that the number of person-year observations is the same for multiple outcomes - as long as a child is enrolled in Medicaid that year, we would have the same number of observations.
Indicator of use of anti-anxiety medication. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of medication fills in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=17 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=47 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Medication Use - Anti-anxiety Medications
|
49,358 person-year observations
|
142,579 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Please note that the number of person-year observations is the same for multiple outcomes - as long as a child is enrolled in Medicaid that year, we would have the same number of observations.
Indicator of use of anti-psychotic medication. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of medication fills in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=17 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=47 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Medication Use - Anti-psychotic Medications
|
49,358 person-year observations
|
142,579 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Please note that the number of person-year observations is the same for multiple outcomes - as long as a child is enrolled in Medicaid that year, we would have the same number of observations.
Indicator of use of attention deficit hyperactivity disorder (ADHD) medications. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of medication fills in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=17 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=47 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Medication Use - ADHD Medications
|
49,358 person-year observations
|
142,579 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Please note that the number of person-year observations is the same for multiple outcomes - as long as a child is enrolled in Medicaid that year, we would have the same number of observations.
Indicator of asthma medications fills. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of medication fills in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=17 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=47 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Medication Use - Asthma Medications
|
49,358 person-year observations
|
142,579 person-year observations
|
SECONDARY outcome
Timeframe: 23 months before policy change (2013), 36 months postPopulation: Children who received ADHD (attention deficit hyperactivity disorder) prescription
Indicator of one or more follow-up visits within 30 days after ADHD (attention deficit hyperactivity disorder) prescription. ACO sample includes any child who was ABD at any point during the study time period enrolled in the ACO. Control sample includes any child who was ABD and who moved from fee-for-service coverage to non-ACO managed care during the study period. Transforms a count of actual number of visits in a year to an indicator that the number was greater than zero.
Outcome measures
| Measure |
Caregiver Survey
n=6 Participants
Caregivers of children with disabilities who are part of the Accountable Care Organization (ACO), and fall into one of three categories: 1) children with Medicaid Aged, Blind, or Disabled (ABD) status with continuous enrollment since July 2013; 2) children with ABD status with 12 month continuous enrollment as of February 2015; and 3) children who were ABD status as of July 2013 who are no longer eligible for ABD but qualify for Medicaid and are still in the ACO.
|
Claims Data-Control Sample
n=18 Participants
Claims and enrollment data from the Ohio Medicaid program from August 2011-July 2016 (23 months before entering ACO, 30 months post); dataset includes children with disabilities on Medicaid under ABD who moved from fee-for-service coverage to non-ACO managed care. Excluded children who enrolled in managed care before the policy change and children not in managed care after the policy change. These are unique participants. They were not consented or considered "enrolled".
|
|---|---|---|
|
Follow-up Within 30 Days After ADHD Prescription
|
75,757 person-year observations
|
214,253 person-year observations
|
Adverse Events
Accountable Care Organization (ACO) Stakeholder Interviews
Caregiver & Youth Focus Groups
Caregiver Interviews
Caregiver Survey
Claims Data-ACO Sample
Claims Data-Control Sample
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Renée Ferrari, PhD
University of North Carolina at Chapel Hill
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place