This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
About 1 in 10 people in the United States have type 2 diabetes. Diabetes can lead to kidney failure, heart attack, stroke, or death. People with diabetes can struggle to get the care they need to manage their condition. These challenges can be worse when people have other health problems or live in poverty.
Several states have programs called Medicaid Health Homes. Health Homes provide care for people who have multiple long-term health problems, such as diabetes and heart disease, or people with serious mental health conditions. In this study, the research team is comparing the health of adult patients with diabetes who are in Health Homes and patients who aren’t. They want to see whether Health Homes affect the way health care is delivered. They also want to see if Health Homes affect the health events that matter most to patients with diabetes, like staying out of the hospital for diabetes-related problems.
Who can this research help?
State policy makers and health clinic managers can use results of this study when considering ways to improve care for people with diabetes.
What is the research team doing?
The research team is combining information from New York’s Medicaid program and a network of seven health systems in New York City. The team is collecting records for 51,000 Medicaid patients who have type 2 diabetes and at least one other health problem. All patients are eligible to get care through the Health Home program. Some patients choose to get care through Health Homes; others do not. The team is tracking patients’ care for five years to see how often patients in both groups go to the hospital because of problems related to diabetes. The team is also studying the quality of health care patients receive.
People with diabetes, clinicians such as doctors and nurses, and diabetes advocates are working with the research team to plan and conduct the study.
Research methods at a glance
|Design||Observational: cohort study|
|Population||51,000 adults who are insured by Medicaid and have Type 2 Diabetes as well as HIV infection, serious mental illness, substance abuse, or multiple chronic conditions|
Primary: diabetes-related preventable hospitalization
Secondary: guideline-concrodant care for diabetes, utilization (outpatient and ER visits, overall hospitalization), glucose control (hemoglobin A1c), diabetes complications, racial/ethnic disparities in quality of care and outcome
|5-year follow-up for primary outcome|
COVID-19 has strained health and social service systems in New York City, which puts the health of people living in poverty at risk. Also, in Medicaid Health Homes, care managers now use telehealth. Telehealth provides services to patients remotely using phone, video, or other devices.
With this enhancement, the research team wants to learn how changes in service delivery affect people who have diabetes, other health problems, and Medicaid. The team will compare records of people who are in Health Homes and people who aren’t. They will look at:
- Access to health care and social services
- Outcomes for people with and without COVID-19
- Disparities by race and ethnicity before and during the pandemic
Enhancement Award Amount: $500,000