Healthcare Provider Referrals for Financial Support in Low-Income Families

Recruiting in Palo Alto (17 mi)

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of California, Los Angeles

Disqualifiers: Acute mental health crisis

No Placebo Group

Trial Summary

What is the purpose of this trial?

The purpose of this study is to pilot test the feasibility, acceptability, and preliminary efficacy of healthcare provider referrals to a tax filing app within parent-child health programs to test whether such referrals can increase receipt of tax credits among low-income parents. The study will use a single-group, pre/post test design with a sample of approximately 100 women who have a child under 6 years of age. Participants will be recruited from parental-child health programs and clinics in Los Angeles and will complete surveys at baseline, immediately after tax filing season, and six months after tax filing season to assess 1) frequency of tax filing after referral (Feasibility), 2) the acceptability of the tax filing app from the perspective of users (Acceptability), and 3) pre/posttest changes to parent and child health, child development, and healthcare utilization measures for users (preliminary efficacy).

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, since the study focuses on tax filing and not medical treatment, it's unlikely that you would need to change your medication routine.

What data supports the idea that Healthcare Provider Referrals for Financial Support in Low-Income Families is an effective treatment?

The available research shows that Medical-Financial Partnerships (MFPs), which include healthcare provider referrals for financial support, can improve both financial and health outcomes for low-income families. Specifically, the study on a pediatric medical home with an embedded Volunteer Income Tax Assistance (VITA) site found that it was a convenient and trusted way to change tax-filing behavior, which can help maximize tax refunds and reduce financial stress. This reduction in financial stress is linked to better health outcomes, making this treatment effective in addressing the root causes of health issues related to poverty. ^{1 2 3 4 5}

What safety data exists for healthcare provider referrals for financial support in low-income families?

The provided research does not contain any safety data related to healthcare provider referrals for financial support in low-income families or related interventions like tax filing services. The studies focus on adverse drug event reporting and electronic health records, which are unrelated to the financial support referral interventions. ^{6 7 8 9 10}

Is the treatment of healthcare provider referral to a tax filing app promising for financial support in low-income families?

Yes, the treatment is promising because it helps low-income families by connecting them to free tax services, which can increase their tax refunds and reduce financial stress. This approach can improve both financial and health outcomes by addressing poverty-related issues. ^{1 3 11 12 13}

Research Team

Eligibility Criteria

This trial is for low-income parents with a child under 6, earning less than $75,000 annually. Participants must have internet access and a valid tax filing ID. It aims to help them get tax credits by using a healthcare provider-referred tax app.

Inclusion Criteria

You have a device that can connect to the internet.

I have at least one child under 6 years old.

You have a Social Security number or Individual Taxpayer Identification Number.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (in-person)

Intervention

Participants receive a referral to a tax filing app during program visits

1 week

1 visit (in-person)

Follow-up

Participants complete a follow-up survey to assess outcome measures after receiving tax refunds

3-6 months

2 visits (virtual)

Treatment Details

Interventions

• Healthcare provider referral to a tax filing app (Behavioral Intervention)

Trial Overview The study tests if referrals from healthcare providers to use a tax filing app can increase the number of low-income families receiving tax credits. About 100 women will be surveyed before, immediately after, and six months post-tax season.

Participant Groups

Group I: Intervention Experimental Treatment 1 Intervention

This arm will receive a healthcare provider referral to a tax filing app

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

Dr. Thomas Rando

University of California, Los Angeles

Chief Medical Officer since 2023

MD from UCLA

Amir Naiberg

University of California, Los Angeles

Chief Executive Officer since 2024

JD from UCLA

Findings from Research

Embedding a Volunteer Income Tax Assistance (VITA) site within a pediatric medical home (PMH) proved to be a convenient and trusted resource for caregivers, potentially changing their tax-filing behaviors.

Many caregivers were unaware of the free tax filing services available through the PMH-VITA site, indicating a need for better marketing to increase awareness and utilization among the target population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Medical Financial Partnership in a Pediatric Medical Home. Markowitz, MA., Harper, A., Rosenthal, MS., et al.[2022]

As of December 2010, nearly 40% of active e-prescribers adopted the technology due to federal incentives, indicating a significant impact of financial motivation on the adoption of e-prescribing.

The federal incentive program led to a 9-11% increase in e-prescribing among existing users, translating to an additional 6.8-8.2 prescriptions per provider each month, showcasing the effectiveness of incentives in enhancing healthcare technology use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

E-prescribing adoption and use increased substantially following the start of a federal incentive program. Joseph, SB., Sow, MJ., Furukawa, MF., et al.[2018]

Medical-Financial Partnerships (MFPs) are innovative collaborations between healthcare systems and financial organizations aimed at reducing financial stress in low-income families, which can lead to improved health outcomes.

MFPs provide a range of financial services, such as coaching and tax preparation, and have shown promise in enhancing both financial stability and health, addressing the link between financial circumstances and health in marginalized communities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Medical-Financial Partnerships: Cross-Sector Collaborations Between Medical and Financial Services to Improve Health. Bell, ON., Hole, MK., Johnson, K., et al.[2023]

Primary care physicians (PCPs) who work with nurse practitioners and physician assistants (NP-PAs) are more likely to manage complex patient conditions themselves rather than referring them to specialists, suggesting that NP-PAs enhance the capacity of PCPs to provide comprehensive care.

The study indicates that managed care factors influence referral patterns, but this effect is mediated by the increased use of NP-PAs, highlighting their role in allowing PCPs to focus on more complex cases and reduce unnecessary referrals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Determinants of primary care physicians' referral pattern: a structural equation model approach. Chung, K., Yang, D., Lee, JH.[2021]

Patients with low financial status (7467 individuals) reported 10% to 30% lower satisfaction with healthcare services and collaborative care compared to those with adequate financial status (43,701 individuals).

Markers of disease management and prevention were also significantly lower (7% to 18%) in patients with low financial status, highlighting that financial disparities negatively impact health outcomes and access to quality care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Postscript: health disparity and collaborative care. Wasson, JH., Benjamin, R.[2019]

In a study analyzing data from nine US states, it was found that counties with lower rates of electronic prescribing had a 10% higher odds of older adults being hospitalized due to adverse drug events, indicating a potential safety concern.

The research suggests that increasing the use of electronic prescribing could help reduce the risk of adverse drug events in older patients, highlighting the importance of health IT in improving patient safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community-level electronic prescribing and adverse drug event hospitalizations among older adults. Bhavsar, GP., Probst, JC., Bennett, KJ., et al.[2020]

Requiring physicians to submit adverse event reports to the FDA Adverse Event Reporting System (FAERS) could significantly improve the quantity and quality of reports, enhancing the ability to determine causality for drug-related issues.

This proposed requirement aligns with existing practices in the Vaccine Adverse Event Reporting System (VAERS) and could be facilitated by advancements in electronic health records, ultimately supporting better drug safety monitoring.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

FDA Adverse Event Reporting System: Recruiting Doctors to Make Surveillance a Little Less Passive. Mann, JM.[2015]

The MOVING program, a virtual interdisciplinary geriatric consultation service, effectively reduced the number of potentially inappropriate medications prescribed to older adults, with significant decreases noted in prescriptions identified by the Beers and STOPP criteria.

While the overall number of prescriptions did not significantly change, the program led to a notable reduction in 'as needed' prescriptions, suggesting improved medication management for older patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outcomes of a Medication Optimization Virtual Interdisciplinary Geriatric Specialist (MOVING) Program: A Feasibility Study. Ho, JM., To, E., Sammy, R., et al.[2023]

The FDA's ASTER pilot study demonstrated that electronic health record (EHR)-triggered adverse event reports can provide valuable postmarketing safety information, particularly for known adverse drug events (ADEs).

However, the quality of the reports varied, with many lacking critical details such as informative descriptions and relevant laboratory data, highlighting the need for improved data quality to enhance the utility of EHR-triggered ADE reporting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Quality assessment of spontaneous triggered adverse event reports received by the Food and Drug Administration. Brajovic, S., Piazza-Hepp, T., Swartz, L., et al.[2012]

Half of the family physicians (50%) enrolled in the Targeted Poverty Screening (TPS) Program, and a significant majority (81.6%) reported screening patients for poverty using a specific evidence-based question, indicating a general willingness to address socioeconomic factors in patient care.

Barriers to poverty screening included forgetfulness and discomfort, suggesting that integrating screening into routine practices and providing additional training could enhance the effectiveness and uptake of poverty screening among family physicians.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving Health Equity by Screening for Poverty: A Survey of Family Physician Screening Behaviors and Perceptions in Toronto, Canada. Chin, C., Amri, M., Greiver, M., et al.[2022]

County-based health care financial assistance programs significantly improve access to care for uninsured and undocumented populations, with strong correlations between program enrollment and the percentage of uninsured (r=0.86) and undocumented individuals (r=0.83).

These programs typically cover the same income range as Medicaid (0-138% of the federal poverty level) and provide similar benefits, including emergency and inpatient care, making them a crucial alternative for those ineligible for Medicaid.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Characteristics of Health Care Financial Assistance Programs Serving the Most Populous U.S. Counties. Zhu, M., Srinivasan, N., Karpe, A., et al.[2022]

The pilot study 'TAX4U' assessed the feasibility of providing free tax services to families in a pediatric hospital, but only 7 out of 39 families (18%) ultimately received the intervention, indicating challenges in reaching eligible participants.

Most families (72%) were ineligible for the tax service due to criteria not aligning with their needs, suggesting that future efforts should focus on creating more inclusive medical-financial partnerships to better support low-income families in hospital settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

TAX4U Pilot Trial: Addressing Material Needs in the Pediatric Hospital Setting. van den Heuvel, M., Zaffar, N., Shah, B., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

A Medical Financial Partnership in a Pediatric Medical Home. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

E-prescribing adoption and use increased substantially following the start of a federal incentive program. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

Medical-Financial Partnerships: Cross-Sector Collaborations Between Medical and Financial Services to Improve Health. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Determinants of primary care physicians' referral pattern: a structural equation model approach. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Postscript: health disparity and collaborative care. [2019]

6. England pubmed.ncbi.nlm.nih.gov

Secondary use of electronic health record data: spontaneous triggered adverse drug event reporting. [2019]

7. England pubmed.ncbi.nlm.nih.gov

Community-level electronic prescribing and adverse drug event hospitalizations among older adults. [2020]

8. United States pubmed.ncbi.nlm.nih.gov

FDA Adverse Event Reporting System: Recruiting Doctors to Make Surveillance a Little Less Passive. [2015]

9. Switzerland pubmed.ncbi.nlm.nih.gov

Outcomes of a Medication Optimization Virtual Interdisciplinary Geriatric Specialist (MOVING) Program: A Feasibility Study. [2023]

10. England pubmed.ncbi.nlm.nih.gov

Quality assessment of spontaneous triggered adverse event reports received by the Food and Drug Administration. [2012]

11. United States pubmed.ncbi.nlm.nih.gov

Improving Health Equity by Screening for Poverty: A Survey of Family Physician Screening Behaviors and Perceptions in Toronto, Canada. [2022]

12. United States pubmed.ncbi.nlm.nih.gov

Characteristics of Health Care Financial Assistance Programs Serving the Most Populous U.S. Counties. [2022]

13. United States pubmed.ncbi.nlm.nih.gov

TAX4U Pilot Trial: Addressing Material Needs in the Pediatric Hospital Setting. [2023]