The Wellness Incentive and Navigation intervention improved health‐related quality of life among Medicaid enrollees: A randomized pragmatic clinical trial

Objective To examine whether the Wellness Incentive and Navigation (WIN) intervention can improve health‐related quality of life (HRQOL) among Medicaid enrollees with co‐occurring physical and behavioral health conditions. Data Sources Annual telephone survey data from 2013 to 2016, linked with clai...

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Bibliographic Details
Published in:Health services research 2019-12, Vol.54 (6), p.1156-1165
Main Authors: Guo, Yi, Vogel, Walter Bruce, Muller, Keith E., Stoner, Dena, Huo, Tianyao, Shenkman, Elizabeth A.
Format: Article
Language:English
Subjects:
Activation
Adult
Behavioral medicine
Clinical research
Clinical trials
Data collection
Demographics
Demography
Extraction
Female
Government programs
Health
Health Behavior
Health Insurance Incentives and Coverage
Health Promotion - methods
Health status
Healthcare industry software
Humans
Intervention
longitudinal
Male
Managed care
Medicaid
Medicaid - statistics & numerical data
Medical research
Middle Aged
Motivation
Motivational interviewing
Navigation
patient activation
Patient Navigation - methods
Patient Participation - psychology
Patient Participation - statistics & numerical data
Polls & surveys
pragmatic clinical trial
Quality of life
Quality of Life - psychology
Randomization
Surveys
Surveys and Questionnaires
Telephone surveys
Texas
United States
Wellness
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Summary:Objective To examine whether the Wellness Incentive and Navigation (WIN) intervention can improve health‐related quality of life (HRQOL) among Medicaid enrollees with co‐occurring physical and behavioral health conditions. Data Sources Annual telephone survey data from 2013 to 2016, linked with claims data. Study Design We recruited 1259 participants from the Texas STAR + PLUS managed care program and randomized them into an intervention group that received flexible wellness accounts and navigator services or a control group that received standard care. We conducted 4 waves of telephone surveys to collect data on HRQOL, patient activation, and other participant demographic and clinical characteristics. Data Collection/Extraction Methods The 3M Clinical Risk Grouping Software was used to extract variables from claims data and group participants based on disease severity. Principal Findings Our results showed that the WIN intervention was effective in increasing patient activation and HRQOL among Medicaid enrollees with co‐occurring physical and behavioral health conditions. Furthermore, we found that this intervention effect on HRQOL was partially mediated by patient activation. Conclusions Providing navigator support with wellness account is effective in improving HRQOL among Medicaid enrollees. The pragmatic nature of the trial maximizes the chance of successfully implementing it in state Medicaid programs.
ISSN:0017-9124
1475-6773
DOI:10.1111/1475-6773.13235