Coventry Outcomes Study of Seniors (COSS): A Comparative Effectiveness Study to Evaluate the Effect of a Multidisciplinary Team's Intervention on the Incidence of Nonelective Hospitalizations in a Medicare Population

Medco Health Solutions

Status: Terminated

Conditions: Osteoporosis; Diabetes; Chronic Obstructive Pulmonary Disease; Heart Failure; Cardiovascular Disease

Treatments: Other: Multidisciplinary team bimonthly visits either in person or via telephone.; Other: Multidisciplinary team interventions; Other: Usual case management and pharmacy management as provided by the health Plan and the pharmacy benefit manager

Study type: Interventional

Funder types: Industry

Identifiers

NCT01014884

7714

Details and patient eligibility

About

The investigators are studying the impact of the interventions of a multidisciplinary team (MDT) - consisting of a Coventry case manager, social worker, and medical director, alongside a Medco specialist pharmacist - on the hospitalization rates of high risk seniors with chronic conditions, compared with a usual care approach. The study will also examine the impact on quality of life, medication adherence, medical costs, hospital readmission rates, and a variety of other important measures. The outcome of COSS may support a means to further enhance and develop a comprehensive care model program by leveraging the partnership between a health plan and a pharmacy benefit manager.

Full description

The multidisciplinary team will provide face-to-face visits in a home setting with interventions that focus on five key areas: care transitions, self-management, care coordination, pharmacy and prevention, all designed to support high-risk Medicare members and their relationship with their primary care providers. If the study proves to reduce hospitalizations in the senior population, it could provide important guidance for future efforts to reduce the cost and improve the quality of care for seniors with chronic conditions.

Enrollment: 2,150 estimated patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Inouye Risk Score >3 calculated on Coventry Claims
• Medicare Advantage beneficiaries age > 65 years
• Continuous eligibility > 12 months prior to study
• Ability to be contacted via telephone
• Subject is willing and able to provide informed consent
• Willing to comply with all study procedures and be available for the duration of the study

Exclusion criteria

• Active cancer treatment (i.e. chemotherapy or radiation) in the past 6 months
• Living anywhere other than a community setting [i.e. Skilled nursing facility (SNF)]
• Just-In-Time (JIT) Members
• Members with a geographic location > 60 from either St. Louis or Kansas City, MO.
• Solid organ transplant recipients
• Active enrollment in another clinical research study

Trial design

2,150 participants in 2 patient groups

Control Group

Other group

Description:

The control group will receive usual care as provided by your Health Plan.

Treatment:

Other: Usual case management and pharmacy management as provided by the health Plan and the pharmacy benefit manager

Intervention group

Other group

Description:

Additional visits will be conducted by a member of the multidisciplinary team (case manager/nurse, social worker and/or pharmacist that will be either face to face or by telephone.

Treatment:

Other: Multidisciplinary team bimonthly visits either in person or via telephone.

Other: Multidisciplinary team interventions