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 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.