AI-Supported Care Engagement for Next-step Delivery - Medicare Advantage

Conditions

• Patient Navigation
• Population Health Management

Eligibility Criteria

Sex

ALL

Age

18 Years - N/A

Healthy Volunteers

Not accepted

Interventions

• AI-Supported Rising-Risk Care Navigation — OTHER
  AI-supported proactive care navigation involves the generation of guideline-informed candidate care-navigation actions from protocol-authorized structured data, human-in-the-loop review by a nurse, and then delivery of the approved suggestion through existing care-management or clinical workflows. The nurse may accept, modify, reroute, or reject each candidate before participant outreach or care-team routing. Reassessment is planned approximately every 90 days and may change intervention delivery, but not assigned-group membership.

Study Details

ASCEND-MA is an embedded, health-services study of at-risk Medicare Advantage members attributed to Intermountain Health in Utah. Participants are quasi-randomized based on their medical-record-number parity to either AI-supported, nurse-reviewed proactive care navigation or usual care. The study will evaluate whether the program changes cumulative payor-paid healthcare spending over 12 months.

Key Dates

First listed

Sep 4, 2026

Start date

Aug 17, 2026

Status verified

Aug 2026

Primary completion

Nov 17, 2027

Completion

Nov 17, 2027

Study Design

Enrollment

9,906 participants (estimated)

Allocation

NON_RANDOMIZED

Intervention model

PARALLEL

Primary purpose

HEALTH_SERVICES_RESEARCH

Arms

• Experimental: AI Supported Rising Risk Care Navigation
  Participants receive routine clinical care plus the AI Supported Rising Risk Care Navigation strategy. The strategy periodically assesses for care opportunities; every candidate nudge undergoes human clinical review before routing or outreach, and no outreach occurs when no clinically appropriate action is identified
• No Intervention: Usual Care
  Participants receive routine clinical care and existing care-management services under standard eligibility and operating rules. The study introduces no AI-supported care-navigation nudges for this arm and withholds no otherwise available care because of assignment

Primary Outcome Measure

Cumulative payer-paid health care spending per participant [ Time Frame: 1 year ]

Locations (1)

Find similar trials in Murray, UT

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