Evidence map›Paper›PMID 27778316›Full record

Trial reportHealth services research2016

Testing the Replicability of a Successful Care Management Program: Results from a Randomized Trial and Likely Explanations for Why Impacts Did Not Replicate.

G Greg Peterson, Jelena Zurovac, Randall S Brown, Kenneth D Coburn, Patricia A Markovich, Sherry A Marcantonio, William D Clark, Anne Mutti, Cara Stepanczuk

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

G Greg PetersonMathematica Policy Research, Washington, DC.
Jelena ZurovacMathematica Policy Research, Washington, DC.
Randall S BrownMathematica Policy Research, Princeton, NJ.
Kenneth D CoburnHealth Quality Partners, Doylestown, PA.
Patricia A MarkovichResearch and Rapid Cycle Evaluation Group, Center for Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services, Baltimore, MD.
Sherry A MarcantonioHealth Quality Partners, Doylestown, PA.
William D ClarkResearch and Rapid Cycle Evaluation Group, Center for Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services, Baltimore, MD.
Anne MuttiMathematica Policy Research, Washington, DC.
Cara StepanczukMathematica Policy Research, Princeton, NJ.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo test whether a care management program could replicate its success in an earlier trial and determine likely explanations for why it did not. DATA SOURCES/

settingMedicare claims and nurse contact data for Medicare fee-for-service beneficiaries with chronic illnesses enrolled in the trial in eastern Pennsylvania (N = 483). STUDY

designA randomized trial with half of enrollees receiving intensive care management services and half receiving usual care. We developed and tested hypotheses for why impacts declined. DATA EXTRACTION: All outcomes and covariates were derived from claims and the nurse contact data. PRINCIPAL

findingsFrom 2010 to 2014, the program did not reduce hospitalizations or generate Medicare savings to offset program fees that averaged $260 per beneficiary per month. These estimates are statistically different (p < .05) from the large reductions in hospitalizations and spending in the first trial (2002-2010). The treatment-control differences in the second trial disappeared because the control group's risk-adjusted hospitalization rate improved, not because the treatment group's outcomes worsened.

conclusionEven if demonstrated in a randomized trial, successful results from one test may not replicate in other settings or time periods. Assessing whether gaps in care that the original program filled exist in other settings can help identify where earlier success is likely to replicate.

Indexed as

Disease ManagementChronic DiseaseHealth ExpendituresHospitalizationHumansInsurance Claim ReviewMedicarePatient Care ManagementPennsylvaniaTime FactorsUnited Statescare coordinationCare managementchronic diseasecost savingsMedicare Coordinated Care Demonstration

Identifiers

PMID27778316
PMCPMC5134141

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.