Increased Connection to Outpatient Care: An Observational Study Assessing the Impact of the Pathways Community Hub on Health Care Utilization.

Abstract

Our study examined health care utilization outcomes among individuals participating in Pathways, a community hub model that employs a community-based workforce to deliver care coordination services, in Southwest Washington. Using community health record and Medicaid claims data between August 2018 and August 2022, we defined our treatment group as Medicaid beneficiaries enrolled in Pathways (N = 395), and our control group as Medicaid beneficiaries referred to any care coordination program (N = 198). We employed difference-in-differences analyses to compare the change over time in the proportion of individuals using care and the amount of health care used per member per year (PMPY). Relative to the control group, the treatment group experienced a significant increase in connection to outpatient care, with a higher proportion accessing primary (9.6%, <i>P</i> = .073), specialty (12.8%, <i>P</i> = .033), and outpatient mental health (11.8%, <i>P</i> = .031) care after enrollment in Pathways. We also observed encouraging trends in acute care use. Participation in Pathways was associated with connection to outpatient health care and promising decreases in acute care use among Pathways participants. Our findings support the evidence base for Pathways as an effective model of care coordination for people with complex health and social needs.