Providing Legal and Social Services to Address the Needs of Health Care Super-Utilizers: Thinking Outside the Box

The research team is assessing the impact of legal services provided to health care super-utilizers through a medical-legal partnership (MLP) by Health, Education & Law Project, Legal Aid of Nebraska and the Nebraska Medical Center on their health and health care use. The investigators are conducting a randomized controlled trial to examine whether the provision of social and/or legal services through MLP to address the social and legal needs of these healthcare super-utilizers will improve their health outcomes and reduce medical care utilization and expenditure. The study findings will provide evidence for a holistic and interdisciplinary approach to alleviate inequality in health and health care for underserved and low-income patients, as well as strengthen integration of health services and systems.


Main: Emergency department visits, annual medical expenditure

Other: Annual medical expenditure, patients’ access to care, alternative measures of medical services utilization, financial barriers to care


All analyses are conducted from an intent-to-treat perspective. A generalized linear mixed effects model or generalized estimating equation is used to examine the association between use of social and legal services and medical care visits, total medical expenditure, and health outcomes after controlling for demographic and socioeconomic indicators and within-subject correlation.

Doctor and patient shaking hands
Grantee and Partner organizations

Legal Aid of Nebraska
Nebraska Medical Center
University of Nebraska Medical Center

Grant status
In Progress
Principal investigators
Hongmei Wang, PhD
Ann Mangiameli, JD
Start date
Award amount
36 months

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