Experts often describe mobile health (mHealth) as the ability to access health care at one’s fingertips – on a mobile phone. Many consumers are using mHealth apps to make appointments, locate urgent care facilities or other providers in their network, pay a medical bill, fill a prescription, monitor their chronic condition or fitness levels, or communicate with their care team. But “mobile health” from clinics on wheels is another health care innovation.
Mobile health clinics are not new, but are experiencing a surge in popularity. A typical mobile health clinic involves patients getting in a van, RV, or bus to have basic preventive screenings, lab work, or consultation with a care team offering prevention and chronic care management. Some clinics have social workers, dentists, and psychologists, and provide postpartum care and services include cancer screenings and tobacco cessation counseling. The patients are often people who move around a lot and lack a medical home. Without the mobile clinic, they may end up in the emergency department (ED), which drives up costs.
Mobile Health Map, an online platform where the mobile clinic community can aggregate data and document the scope, geographic reach, and value of mobile clinic services, is a collaboration between researchers and the Mobile Health Clinics Association. The organization reports that around 2,600 mobile clinics in the US provide around 6 million annual visits. Some hospitals are investing in the clinics as part of their investment into preventive and chronic care. While building a mobile medical facility is a big investment, research shows it can save money in the long run if it gets patients the care they need and prevents complications and ED visits.
Many health plans are also investing in mobile health: Highmark recently launched a mobile clinic program in rural areas in Pennsylvania and West Virginia to increase access for about 5 percent of its members covered through Medicaid, Medicare Advantage, and exchange plans. The program targets at-risk members who forgo medical care. Highmark aims to better target the members purchasing plans through the exchanges, who have more costly health conditions than the plan anticipated. Ensuring these patients get preventive and chronic care management services may keep health care costs down. The health plan is starting small, with one mobile clinic, and will assess the program over time.
Analysis: Mobile clinics travel to urban and rural communities to provide convenient and accessible services to vulnerable populations. An article in the American Journal of Managed Care finds that these clinics operate in every state across the country and are often affiliated with hospitals, community health centers, or academic medical centers. While many are funded through philanthropy and state and federal grants, independent companies and private insurance providers are increasingly sources of financial support.
The article highlighted significant cost-savings, mostly in the form of avoidable hospital and ED visits, from the use of these clinics. One study showed that the improved hypertension control was associated with a lower-bound return on investment estimate of 1.3 due to avoided ED visits. Another study showed mobile clinics increased medication adherence and decreased ED visits, hospitalizations, and school absenteeism for children with asthma and saved $3,500 per child from improved asthma control. A study that aggregated data from 10 large mobile clinics estimated cost savings of $6.8 million from avoidable ED visits over a 1-year period.
As health plans and providers continue to create innovative prevention and chronic care management strategies and try to decrease hospital admissions and ED visits, they might consider both kinds of “mobile health” strategies.
Caterina F. Hill et al, “Mobile health clinics in the era of reform,” American Journal of Managed Care, March 20, 2014; Highmark, “Highmark’s doctor’s office on wheels connects doctors and nurses with members who face barriers getting to the doctor, May 12, 2016; Mobile Health Map, www.mobilehealthmap.org
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