Geriatric Care Management Study: Kaiser Permanente Community Partners Project

In 1998 Kaiser Permanente TriCentral Service Area in partnership with Partners In Care Foundation and the L.A. County and L.A. City Area Agencies on Aging (AAA), received a four year grant from the California HealthCare Foundation’s Program for Elders in Managed Care to test models of Geriatric Care Management and to determine whether geriatric care management plus a brief payment intervention (up to $2,000 of designated paid services (such as in-home supportive services, transportation, respite or medical equipment) would lower medical costs, improve satisfaction with care, increase care plan adherence and improve perceived quality of life. An additional aim of this project was to determine if improved collaboration between KP and AAA agencies would result in improved patient outcomes.

From May 2000 to September 2001, patients were screened and enrolled into the KPCP study resulting in a total of 451 participants randomized: 98 to information and referral, 113 to telephone care management, 117 to GCM, and 123 to GCM plus purchase of service. Based upon the varied levels of analyses conducted it was evident that the interventions tested in this study did not have a significant impact on the dependent variables being tested. In fact, analyses demonstrated that all groups had equal outcome at 12 months following study enrollment. Hence, higher, more costly levels of GCM did not measurably improve patient outcomes in terms of functioning, service use, depression, caregiver burden, and cognition. Further, the added $2,000 benefit, which was not widely accepted and used by the study sample, did not help to improve patient outcomes.