Setting of Care
The Dentists' Partnership offers free oral health care to low-income individuals in exchange for community service, resulting in a 70-percent decline in emergency department visits for urgent dental conditions, a positive return on investment, and high levels of dentist and patient satisfaction.
A mobile clinic provides screening, education, coaching, and health navigation services to residents of four underserved communities, leading to the identification of many previously undetected chronic conditions, better blood pressure control, and a substantial return on investment.
A community cancer coalition employs navigators who work with community health centers in rural areas to identify those in need of colorectal cancer screening via colonoscopy and facilitate access to such screening, leading to more referrals and screenings and to more cancers and precancerous polyps being detected and treated.
Neurologists with expertise in movement disorders enhance access to specialty care by offering virtual house calls to patients with Parkinson's disease, generating very high levels of patient satisfaction.
The Georgia Medicaid program expanded the definition of reimbursable services provided by mental health peer specialists to include physical health and wellness services, resulting in the training and certification of 175 such specialists to provide these services and in anecdotal reports of improved physical health outcomes among clients who receive the services.
Massachusetts banned ambulance diversions and helped hospitals respond to the ban by improving patient flow, leading to reductions in emergency department length of stay for admitted patients, shorter turnaround times for ambulances, and strong support from emergency department leaders who believe the ban has yielded multiple benefits.
An emergency medical services system uses a data-driven program to identify frequent 911 callers and facilitate access to community-based medical, social service, and other interventions to address their underlying needs, leading to significant reductions in emergency transports and associated costs.
With support from State funding, a community mental health center provides integrated mental health, primary care, care coordination, and wellness services to Medicaid beneficiaries with severe and persistent mental illness, leading to better chronic disease outcomes.
The California Public Employees' Retirement System generated significant cost savings by adopting reference pricing for hip and knee replacement procedures, causing enrollees to migrate to high-value facilities and encouraging high-price hospitals to lower their fees.
An emergency department uses an eight-variable risk assessment tool to determine which patients should be tested for undiagnosed HIV, leading to the identification of the same number of HIV-positive patients as through universal screening, thus suggesting greater cost-effectiveness.