Data from Massachusetts General Hospital Provide New Insights into Managed Care (Utilization by high-cost, high-need Medicaid patients receiving social worker care coordination): Managed Care

2026 MAY 13 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Research findings on Managed Care are discussed in a new report. According to news originating from Boston, Massachusetts, by NewsRx correspondents, research stated, “Office-based care coordination programs are increasingly utilizing social work-trained care coordinators to manage high-cost, high-need (HCHN) patients with increased psychosocial risk, including patients covered by Medicaid. Whether utilization of social worker care coordinators (SWCCs) with HCHN Medicaid patients impacts health care utilization is not clear, so we conducted a wait-list randomized controlled trial to test whether social worker care coordination decreases health care utilization and costs in HCHN Medicaid patients.”

Our news journalists obtained a quote from the research from Massachusetts General Hospital, “Prospective enrollment with computer randomization 1:1 to an intervention group receiving SWCC office-based care coordination or to a control group. HCHN patients (N = 252) were randomly assigned to enrollment in an office-based care coordination program with SWCC engagement or to a wait-list control group. Total numbers of emergency department (ED) visits and hospitalizations and total medical expenditure (TME) within the preceding 12 months were collected at baseline and then again at 1 year and 2 years after study group assignment. Health care utilization and costs were compared using mixed-effects models. Patients enrolled in an outpatient SWCC program had an increased number of hospitalizations compared with wait-listed control patients. There were no differences in the number of ED visits or in TME between groups.”

According to the news editors, the research concluded: “Enrollment for up to 2 years in an office-based social worker-led care coordination program did not reduce health care utilization or costs in HCHN Medicaid patients.”

This research has been peer-reviewed.

For more information on this research see: Utilization by high-cost, high-need Medicaid patients receiving social worker care coordination. The American Journal of Managed Care, 2026;32(4). The American Journal of Managed Care can be contacted at: Managed Care & Healthcare Communications Llc, 666 Plainsboro Rd, Ste 300, Plainsboro, NJ 08536, USA.

The news correspondents report that additional information may be obtained from Nicolas M. Oreskovic, Division of General Internal Medicine, Dept. of Medicine, Massachusetts General Hospital, 125 Nashua St, Ste 8406, Boston, MA 02114. Additional authors for this research include Ann E. Erwin, Zachary A. Allon, Hang Lee and Marcela G. Del Carmen.

The publisher’s contact information for the The American Journal of Managed Care is: Managed Care & Healthcare Communications Llc, 666 Plainsboro Rd, Ste 300, Plainsboro, NJ 08536, USA.

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