Utilization of a Mobile Integrated Healthcare Program in Richland County, South Carolina to Provide Access to Care, Lower Costs, and Improve Health Outcomes


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The Richland County Mobile Integrate Health Unit (RCMIH) began operations in 2015 funded through a grant from Blue Cross Blue Shield of South Carolina and continues now funded directly by the County EMS budget. Due to a shortage of primary care physicians, as well as a large underfunded and uninsured population, overutilization of 911 Emergency Medical Services (EMS) transports, emergency department (ED) visits, and unnecessary hospitalizations are quite common in the community. By identifying and enrolling high risk individuals into the RCMIH program, we aimed to improve access to care, lower costs of care, and decrease ED visits and inpatient hospitalizations. Using 911 call logs, patients were identified as high utilizers and offered enrollment into the RCMIH program. Since inception, 1526 individuals have been referred to the RCMIH program with a retention/engagement rate of seven-eight percent and a total of 9908 patient interactions. The average length of patient enrollment is currently thirty-six days. RCMIH personnel focused on plan of care reviews, disease education, and medication checks during all patient interactions. Information on how to contact RCMIH is also provided during encounters. Enrolled patients were tracked for EMS utilization, ED visits and hospitalizations from three months pre-enrollment to twelve months after graduating from the RCMIH program. Enrolled patients were noted to have a forty-six percent reduction in EMS use, a forty percent reduction in ED visits, and a sixty-eight percent reduction in hospital admissions in the three months pre-enrollment compared to three months post-enrollment. Estimated cost-savings were calculated to be over $8,000 per enrolled patient. The RCMIH program reinforces the success of MIH and Community Paramedicine programs and their ability to decrease healthcare costs while improving access to care.



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