The shift to value-based payment models increases health care providers’ financial accountability for coordinating care, reducing costs, and improving health outcomes.
To achieve these goals and improve the health of its community, association member Eskenazi Health, in Indianapolis, began offering wraparound services onsite at nine federally qualified health centers in 2011. Eskenazi Health previously provided referrals to outside providers of these services, including behavioral health, social work, dietetics, patient navigation, and respiratory therapy for asthma education.
A Health Affairs article, co-authored by Eskenazi Health CEO Lisa Harris, MD, links the colocation of wraparound services with primary care to a reduction in hospitalizations and emergency department (ED) visits.
Researchers evaluated data from more than 14,000 patients who received care at Eskenazi Health from 2006 to 2016. Receipt of wraparound services was associated with a 7 percent drop in the expected number of hospitalizations and a 5 percent reduction in ED visits during the following year. Researchers estimate these services saved between $8.2 and $14.2 million from 2011 to 2016, based on median hospitalization costs, averaging $1.4 to 2.4 million in annual savings.
“Early intervention and effective chronic disease management are vital to keeping people out of the hospital and reducing the burden of illness on the patient and on the health care system,” Harris said. “We know, based on our research, that our best opportunity to improve the lives of our patients and, by extension, the health and vitality of our community, lies in helping individuals stay well.”
This study demonstrates the potential of value-based payment models, which create incentives for hospitals and other health care providers to look beyond clinical services to meet the social and other support needs that influence patients’ health outcomes. As essential hospitals explore offering or expanding wraparound services to meet patient and community needs, these findings suggest that doing so within a value-based payment model could help reduce avoidable health care use and realize cost savings.
To learn more about how Eskenazi and other essential hospitals are targeting patient needs outside of the traditional care model, visit essentialcommunities.org.