Conclusions
In this randomized clinical trial including medically and socially complex patients at an urban FQHC with high rates of acute care utilization, our A-ICU intervention did not reduce hospitalizations or ED visits at 6 months but increased primary care visits and improved patient-reported social functioning and self-reported health status. These programs provide important benefits beyond utilization reductions. Short-term utilization reduction may not be achievable with intensive primary care programs alone, but whether their short-term benefits lead to longer-term effects on utilization merits further study.