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TOPLINE:

Implementation of the Individualized Management for Patient-Centered Targets (IMPaCT) program, delivered remotely through a standardized community health worker (CHW) intervention within an integrated health system, was associated with a decrease in hospitalizations and an increase in primary care visits at 6 months.

METHODOLOGY:

• IMPaCT is a standardized intervention involving CHWs that previously demonstrated favorable results in healthcare. Researchers conducted a prospective evaluation to examine its effects on healthcare use within an integrated healthcare system in Oregon.
• They enrolled 1230 adults from low-income areas between July 2020 and July 2021 and randomly assigned them to receive usual care (n = 410; mean age, 64 years; 63.9% women) or the IMPaCT intervention (n = 820; mean age, 61.6 years; 63.8% women); overall, nine CHWs, one manager, and one program director were involved.
• CHWs conducted in-depth interviews to understand the social needs and health-related goals of the intervention group and provided weekly coaching and support over 3 months, predominantly through remote communication due to the COVID-19 pandemic. They also delivered food boxes as needed.
• Primary outcomes were hospitalization and emergency department use measured as total hospital days and emergency department visits, respectively, per 1000 members per month in the 6 months after enrollment. The proportion of patients having at least one primary care visit at 6 months post-enrollment was also assessed.

TAKEAWAY:

• Compared with the usual care group, the intervention group experienced a relative reduction in hospital stays (−172.3 days per 1000 members per month; P = .022) at 6 months after enrollment.
• After 6 months, the proportion of patients with at least one primary care visit was higher in the intervention group than in the usual care group (85.7% vs 79.5%; P = .006).
• No significant differences in emergency department visits were observed between the groups.
• The intervention was implemented with high fidelity, successfully maintained after 3 years, and expanded to additional clinical sites.

IN PRACTICE:

“Our findings suggest that standardized CHW interventions may be able to achieve significant reductions in acute care utilization across a wide range of health systems and care settings, even when delivered remotely,” the authors wrote.

SOURCE:

This study was led by Aditi Vasan, MD, MS, of the Division of General Pediatrics at the University of Pennsylvania Perelman School of Medicine in Philadelphia. It was published online on April 11, 2025, in the Journal of General Internal Medicine.

LIMITATIONS:

Notable differences existed in the baseline demographic as well as healthcare utilization between the intervention and usual care groups. The frequency of encounters of each patient with a CHW was not measured, nor were the differences in utilization based on patient engagement levels. The acceptability of the intervention was not evaluated among the patients.

DISCLOSURES:

This program evaluation received funding through the Dissemination and Implementation Award from the Patient-Centered Outcomes Research Institute. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.