TY - JOUR
AU - L. O'Connor
AU - O. Dunn
AU - S. Merolle
AU - C. Salaun
AU - B. Valentiner
AU - J. Rowe
AU - A. Ulintz
AU - T. Boardman
AU - J. M. Otero
AU - M. Reznek
AU - S. A. Goldberg
AU - R. Konrad
A1 - 
AB - OBJECTIVES: Mobile integrated health programs have emerged as a means to reduce avoidable emergency department (ED) visits and optimize healthcare resource utilization. Such models are estimated to cost less than ED encounters but may be more costly than traditional ambulatory services. However, mobile integrated health is not reimbursed by most payors, and its operational costs are poorly understood. Our objective if this study was to estimate the costs of delivering acute care services through a mobile integrated health program. METHODS: This study was performed at an urban academic tertiary care center with a hospital-affiliated emergency medical services agency in which a mobile integrated health program is embedded. Home visits are conducted by paramedics who collaborate with a remotely located, actively engaged physician to evaluate and treat patients. We compiled cost data derived from real-world mobile integrated health patient encounters to account for all the resources needed to perform acute care visits. Mobile integrated health visits were categorized as basic, involving lower complexity evaluations with limited diagnostics, or advanced, which include higher acuity care with intravenous medications and multiple diagnostic studies. We used Monte Carlo simulations to provide probabilistic estimates of the cost per visit of mobile integrated health-facilitated care. RESULTS: Using a Monte Carlo simulation with 1,000 iterations, we established cost estimates for basic and advanced service categories of mobile integrated health services. The median cost of a basic call is $550 (90% CI [$512-$676]), and $1400.00 for an advanced call (90% CI [$810-$1,813]). CONCLUSION: This project, which generated real-world cost estimates for mobile integrated health programs delivering acute care services, offers essential context for policymakers and payors evaluating sustainable reimbursement models. We estimate that mobile integrated health services cost more than the mean cost of most outpatient clinic visits ($160) but remain substantially less expensive than emergency department visits ($2,715) or inpatient admissions ($24,680). These findings should be interpreted with caution, given the limitations of simulation-based estimates in a single system. They highlight the ongoing need to prospectively and rigorously assess the cost-effectiveness of mobile integrated health models.
AD - University of Massachusetts Chan Medical School, Department of Emergency Medicine, Worcester, Massachusetts.; Worcester Polytechnic Institute, School of Business, Worcester, Massachusetts.; University of Florida, Department of Emergency Medicine, Gainesville, Florida.; The Ohio State University College of Medicine, Department of Emergency Medicine, Columbus, Ohio.; Fire Division, Lake County Board of County Commissioners, Mascotte, Florida.; Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts.
AN - 42054124
BT - West J Emerg Med
C5 - Financing & Sustainability; Education & Workforce
CP - 2
DA - Feb 12
DO - 10.5811/westjem.48521
DP - NLM
ET - 20260212
IS - 2
JF - West J Emerg Med
LA - eng
N2 - OBJECTIVES: Mobile integrated health programs have emerged as a means to reduce avoidable emergency department (ED) visits and optimize healthcare resource utilization. Such models are estimated to cost less than ED encounters but may be more costly than traditional ambulatory services. However, mobile integrated health is not reimbursed by most payors, and its operational costs are poorly understood. Our objective if this study was to estimate the costs of delivering acute care services through a mobile integrated health program. METHODS: This study was performed at an urban academic tertiary care center with a hospital-affiliated emergency medical services agency in which a mobile integrated health program is embedded. Home visits are conducted by paramedics who collaborate with a remotely located, actively engaged physician to evaluate and treat patients. We compiled cost data derived from real-world mobile integrated health patient encounters to account for all the resources needed to perform acute care visits. Mobile integrated health visits were categorized as basic, involving lower complexity evaluations with limited diagnostics, or advanced, which include higher acuity care with intravenous medications and multiple diagnostic studies. We used Monte Carlo simulations to provide probabilistic estimates of the cost per visit of mobile integrated health-facilitated care. RESULTS: Using a Monte Carlo simulation with 1,000 iterations, we established cost estimates for basic and advanced service categories of mobile integrated health services. The median cost of a basic call is $550 (90% CI [$512-$676]), and $1400.00 for an advanced call (90% CI [$810-$1,813]). CONCLUSION: This project, which generated real-world cost estimates for mobile integrated health programs delivering acute care services, offers essential context for policymakers and payors evaluating sustainable reimbursement models. We estimate that mobile integrated health services cost more than the mean cost of most outpatient clinic visits ($160) but remain substantially less expensive than emergency department visits ($2,715) or inpatient admissions ($24,680). These findings should be interpreted with caution, given the limitations of simulation-based estimates in a single system. They highlight the ongoing need to prospectively and rigorously assess the cost-effectiveness of mobile integrated health models.
PY - 2026
SN - 1936-900X (Print); 1936-900x
SP - 445
EP - 451+
ST - A Cost Analysis of Mobile Integrated Health for Acute Care
T1 - A Cost Analysis of Mobile Integrated Health for Acute Care
T2 - West J Emerg Med
TI - A Cost Analysis of Mobile Integrated Health for Acute Care
U1 - Financing & Sustainability; Education & Workforce
U3 - 10.5811/westjem.48521
VL - 27
VO - 1936-900X (Print); 1936-900x
Y1 - 2026
ER -