Improving care for disadvantaged Medicare patients to reduce hospitalizations
Official title: Care in the Comprehensive Care Physician (CCP) Program vs. Care in the Comprehensive Care Community and Culture Program (C4P) vs. Care in the Traditional Care
Run by University of Chicago · NCT04489693 · Data updated 2026-11-12
This study is testing three different ways to provide care for low-income Medicare patients at high risk of going to the hospital to see which one helps them stay healthier and happier.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 3000 (estimated) |
| Sponsor | University of Chicago Academic / other |
| Locations | 1 site (Chicago, Illinois) |
| Status | Recruiting |
| Started | March 6, 2019 |
| Main results expected | July 31, 2027 |
| Study ends | July 31, 2029 |
| Registry record updated | April 9, 2025 |
| Trial ID | NCT04489693 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates are socioeconomically disadvantaged Medicare patients who have been hospitalized at least once in the past two years or are in the emergency department at the time of recruitment.
✕Probably not a fit
Patients who do not meet the Medicare eligibility criteria or have not been hospitalized recently may not benefit from this study.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This randomized trial evaluates the effectiveness of three different care coordination models for socioeconomically disadvantaged Medicare patients at high risk of hospitalization. Participants will receive care through either an Ambulatory Care Coordinator Team (ACCT), a Comprehensive Care Physician Program (CCP), or a Comprehensive Care Community & Culture Program (C4P) that includes additional support for social needs. The study aims to assess the impact of these models on hospitalization rates, patient engagement, satisfaction with care, and overall health outcomes. By addressing both medical and social needs, the trial seeks to provide evidence on effective strategies for reducing health disparities.
Why it matters
Potential benefit: If successful, this study could lead to reduced hospitalization rates and improved health outcomes for vulnerable Medicare patients.
How similar studies have gone: Other studies have shown promise in improving care coordination for high-risk populations, but this specific approach is relatively novel.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Must have Medicare Part A and Part B * Must have been hospitalized once in the past 2 years or be in emergency department at time recruitment is initiated Exclusion Criteria: \- None
Where it's running
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David Meltzer
Chicago, Illinois, United States Recruiting
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.