Project Summary

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 Elements Description
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
  • Participation in a Health Home
  • Usual Care

Primary: diabetes-related preventable hospitalization

Secondary: guideline-concordant 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

Timeframe 5-year follow-up for primary outcome

Project Information

Victoria Mayer, MD, MS
Icahn School of Medicine at Mount Sinai
The Impact of Medicaid Health Homes on Patients with Diabetes

Key Dates

January 2016
September 2022

Study Registration Information


Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: October 16, 2023