Hospitals and medical groups now realize the significant impact upon health, chronic illnesses, outcomes and a reduction of readmissions. This may be due to Medicare's quality measure for rates of readmission. CMS penalizes hospitals for increased readmission rates. Thorough discharge planning can make a difference. Although skilled nursing facilities (SNF) make a difference they are not always necessary if alternative non-medical housing can make a difference.
California, with Los Angeles and San Francisco and Seattle, WA. high on the list for homelessness. State governments are now reacting to crisis planning on significant amounts of money to help correct the problem. The rate of homelessness in Medi-Cal beneficiaries increases the cost of health care to taxpayers. In the long run, ameliorating the homeless can offset or decrease health expenditures. If you are homeless there is no access to mail, no street address, probably no transportation unless you live in a car or van. Homelessness is a bad place, with poor hygiene
Health systems are making significant investments in programs that address social determinants of health, such as housing, employment, and food security, according to a new study published in Health Affairs.
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Ridesharing can overcome missed appointments when hospitals share cost or contract with Uber or Lyft to provide transportation. Missed appointments contribute to deterioration and lower ED visits. Transportation is a key social determinant impacting patient outcomes. Without access to reliable, affordable, and convenient transportation, patients miss appointments and end up costing providers.
Missed appointments and care delays cost the healthcare industry $150 billion each year, and individual organizations lose revenue for every patient who does not show up for a scheduled appointment.
Patients without transportation are also less likely to adhere to medication regimes. One study found that 65 percent of patients felt transportation assistance would enable them to fill prescriptions after discharge. Other research has also shown that Medicaid reimbursement restrictions for transportation payments resulted in fewer prescription refills.
“There is a strong business case for hospitals and health systems to address transportation needs since individuals experiencing these issues are more likely to miss appointments or not fill prescriptions, leading to delays in care and potentially to disease progression and complications or readmissions,” To recoup revenue and improve care quality, some health systems like MedStar Health and Denver Health Medical Center are teaming up with Uber, Lyft,
In the analysis of public announcements of new social determinants of health programs operated by US health systems from Jan. 1, 2017, to Nov. 30, 2019, researchers from New York University uncovered at least a $2.5 billion in investments from 57 health systems that collectively included 917 hospitals. The health system funds were allocated to 78 unique programs launched during that time.
About two-thirds of the total investment ($1.6 billion) was specifically committed to housing-focused efforts, followed by employment (28 programs, $1.1 billion), education (14 programs, $476.4 million), food security (25 programs, $294.2 million), social and community context (13 programs, $253.1 million), and transportation (6 programs, $32 million).
“Historically, hospitals have tended to provide community benefit through uncompensated or subsidized care rather than through investment in activities not directly related to health,” they wrote in the study. But now, health systems have found a new strategy to improve outcomes and lower costs outside the walls of their organization.
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