Intensive Care Management of a Complex Medicaid Population: A Randomized Evaluation

Jack S. Rowe
Joy Gulla
Maryann Vienneau
Lisa Nussbaum
Erin Maher
Mallika L. Mendu
Lori Wiviott Tishler
Eric Weil
Sreekanth K. Chaguturu
Christine Vogeli
Peer-Reviewed Article
September 2022


An intensive care management intervention led to over $23,000 savings per year in total medical expenses for participating high-risk Medicaid accountable care organization (ACO) enrollees. 


Mass General Brigham launched the Integrated Care Management Program Patients Linked to Urgent Support (iCMP PLUS) program by subcontracting with Commonwealth Care Alliance to deliver intensive, community-based primary care and care management with an interdisciplinary team to Medicaid ACO patients with the highest cost and utilization histories. This randomized controlled quality improvement trial assessed the impact of the iCMP PLUS intervention on costs and utilization. This article also provides detail on the team roles, program costs, and patient identification methodology of this intervention.


Patients who received this care management intervention had significantly reduced total medical expenses when compared to the control group, though the decrease in utilization among the intervention group was not statistically significant. The program led to annual savings of over $23,000 per participating patient. This cost reduction was likely related to altered emergency department practice change, narrow focus on eligible patients, patient engagement across multiple sites of care, and care team composition.


This study demonstrates the value of enhanced care management programs and highlights opportunities for large health systems to partner with community-based primary care organizations. While this pilot study was small, it highlights how health care organizations can identify those patients most likely to benefit from this kind of intervention.

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