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Can AI help nurses guide At-Risk seniors to better care and lower costs?

NCT ID NCT07804095

Disease control Sponsor: Intermountain Health Care, Inc. Source: ClinicalTrials.gov ↗

What the study statuses mean

This study's is highlighted.

Recruitment status, easiest to join first

Recruiting now
This trial is taking on new participants right now.
Not yet recruiting
Registered, but not yet taking participants.
By invitation only This study
Not open to general applications. Only people the study team invites can take part.
Paused
Paused for now. It may or may not start again.
Ongoing
Running, but no longer taking on new participants.
Completed
The trial has finished. Results may not be published yet.
Stopped early
Stopped early, before it reached the end. That can be for many reasons, including safety.
Cancelled
Cancelled before anyone took part.

Expanded access (not trials)

Expanded access
Not a trial. This treatment can be requested outside a study, case by case, for people who qualify.
Expanded access (paused)
Not a trial. The treatment can normally be requested outside a study, but is unavailable right now.
Expanded access (ended)
Not a trial. The treatment could once be requested outside a study, but no longer can.
Approved
The treatment has been approved, so it is available normally rather than through this programme.

When the status isn't known

Details not published
The full record has not been published yet, so there is little to show here.
Status unknown
This status has not been confirmed recently, so it may be out of date.

First seen Sep 04, 2026 · Last updated Sep 04, 2026

Summary

This trial tests whether an AI system that flags at-risk Medicare Advantage members and suggests care actions, reviewed by a nurse, can reduce overall healthcare spending over a year. About 9,900 participants in Utah are assigned to either this AI-supported navigation or usual care. The study tracks total payer-paid costs and acute-care episodes like hospital visits to see if proactive, AI-assisted guidance makes a difference.

What this could mean

Our plain-language read of the trial. This is informational only, not medical advice or a prediction.

Active substance
AI-supported proactive care navigation with nurse review
What this could lead to
If it works, this approach could help health systems identify at-risk patients earlier and guide them to appropriate care, potentially reducing hospitalizations and overall healthcare spending.
What could go wrong
The intervention relies on AI predictions and nurse judgment, which may not always catch the right patients or actions. Also, results from one health system in Utah may not apply to other populations or regions.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Not a phased trial

Phase numbers describe drug development. The registry uses this when they do not apply, as it does for trials of devices, procedures or behaviour changes, and for observational studies.

Participants

About 9,906 people

The number the study aims to enrol. It can still change while the study runs.

Started

Aug 2026

Expected to finish

Nov 2027

An estimate. End dates often move.

Lead sponsor

Other sponsor

The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

18 years and older

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: •.Enrolled in an eligible Medicare Advantage plan and attributed to Intermountain Health in Utah. * Continuous Medicare Advantage enrollment for at least 6 months before the index date. * PRM Rising-Risk score (an internally derived prediction model) of at least 0.70 and Current-Risk score below 0.95 at index * Predicted year-over-year cost increase of at least 30%. * At least one targeted chronic condition: diabetes mellitus, heart failure, chronic obstructive pulmonary disease, chronic kidney disease, hypertension, or hyperlipidemia. Exclusion Criteria: * Hospice enrollment at index. * End-stage renal disease requiring chronic dialysis at index. * Active oncology treatment at index. * Long-term institutional residence, including skilled-nursing-facility residence, at index. * Primary language cannot be supported through patient-directed outreach and no feasible alternative care-team communication pathway is available.

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Conditions

The condition(s) this trial relates to.

chronic kidney disease chronic obstructive pulmonary disease diabetes mellitus heart failure hyperlipidemia hypertensive disorder Patient Acceptance of Health Care

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Patient navigation Population health management

How to take part

Only the study team decides who joins. These are the ways to reach them.

  1. The places running it

    1 site. The list below names each one and where it is.

  2. The official record

    The full official record for this study. This one lists no contact details, but it is the first place any would appear.

    Open the record ↗

  3. A doctor treating you

    A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.

Contacts and locations

Locations

  • Intermountain Health - ASCEND-MA Statewide Cohort

    Murray, Utah, 84107, United States

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