Dynamics of patient targeting for care management in Medicaid: a case study of the Durham Community Health Network.

Journal Article (Journal Article)

Targeting appropriate patients for care management is crucial to maximizing quality of care and cost-effectiveness in Medicaid care management programs. This study examined patient characteristics predicting selection for care management pre- and postmanagement changes at the Durham Community Health Network (DHCN), one of North Carolina's Medicaid primary care management networks. From the beginning, care managers were directed to target asthmatics, diabetics, and high-volume utilizers of health care, using an array of markers to identify patients who needed management. In 2003, the state reinforced its focus on chronic disease and high utilizers, and new management at DCHN began emphasizing the use of protocols for patient targeting. This study examined the relative effects of patient demographics, diagnoses, PCP group, and health care utilization as predictors of patient selection before and after these changes.

Full Text

Duke Authors

Cited Authors

  • Horvath, B; Silberberg, M; Landerman, LR; Johnson, FS; Michener, JL

Published Date

  • 2006

Published In

Volume / Issue

  • 7 / 3

Start / End Page

  • 107 - 114

PubMed ID

  • 17214243

International Standard Serial Number (ISSN)

  • 1521-0987

Digital Object Identifier (DOI)

  • 10.1891/cmj-v7i3a001


  • eng

Conference Location

  • United States