The Livingston/Washtenaw County Community Health Innovation Region’s Social and Medical Care Coordination pilot was carefully constructed¬† to identify the impact of coordinated health and human service delivery, including temporary housing, food and nutrition assistance, transportation assistance, and other social services, on the health and welfare of community members who are frequent users of hospital emergency department services.

To do this, research partners are collecting pre- and post-intervention data from patients, health and human service care managers, Medicaid claims, insurers, and others. This anonymized data is being evaluated by the Michigan Department of Health and Human Services as well as by researchers from Michigan State University, the University of Michigan, the Child Health Evaluation Research Center (CHEAR), the Michigan Public Health Institute (MPHI), and other approved organizations.

In addition, with funding from the Community Foundation for Southeast Michigan, Professor Andy Ryan of the University of Michigan School of Public Health will use a randomized-control trial, known as gold standard methodology, to assess the impact of the intervention.

Participants will enter the intervention pool either through local referrals or through a predictive model that analyzes 441 data points to identify individuals who are likely to become high frequency users of emergency department services. The intervention will be offered to a random selection of participants identified through the predictive model, and the remaining individuals will receive traditional treatment. After 12 months, the traditional treatment individuals will also be invited to join the intervention.