Literature Collection

The authors aimed to investigate potential differences between health care use and related payments for patients with complex needs and high costs in Health Resources and Services Administration-funded health centers (HCs) and with other safety net primary care providers. The authors used data from the California Health Homes Program that was designed to improve health outcomes and reduce expenditures of such Medicaid managed care beneficiaries. The authors used 2018 data prior to program implementation and conducted propensity score-matched regressions. The authors then estimated predicted rates of use across seven service categories and payment values for each category and for overall payments. The authors found that 29% of the sample were HC patients and had lower estimated average total payment values ($21,220) than group provider patients ($23,180). HC patients also had lower values for hospitalizations and long-term facility stays and higher values for primary and mental health services than all other providers. Payment differences were generally consistent with differences in predicted rates of use. These findings suggest that HC approaches to managing patient care access and integrated mental health services may explain these differences in use and payment patterns.

Autonomous mobile clinics (AMCs) have the potential to revolutionize healthcare delivery by bringing healthcare services to patients at the order of patient's fingertips. Particularly, AMCs can act as an essential touch point of integrated care, which is a worldwide response to the fragmented delivery of health by focusing on more coordinated and integrated forms of care provision. However, the impact of AMCs on the health satisfaction outcome effectiveness still remains unknown. In this article, in collaboration with United Family Healthcare (UFH), we study the potential effectiveness improvement of integrated care delivery through AMCs.