Nav: Home

Wraparound services hold great promise for reducing health costs and improving outcomes

October 03, 2018

When Eskenazi Health in Indianapolis began offering on-site dietetics, social work and other wraparound services at its clinics, it did more than improve patient outcomes. It potentially saved millions of dollars in hospitalization costs.

A new paper co-authored by Lisa Harris, CEO of Eskenazi Health, Paul Halverson, founding dean of the Richard M. Fairbanks School of Public Health at IUPUI, and Joshua Vest, lead author of the paper and an associate professor of health policy and management at the Fairbanks School of Public Health, finds that the wraparound services, co-located within the primary care setting of the large urban safety-net health provider, were associated with a reduction in the number of hospitalizations and emergency room visits.

"Providing nonmedical wraparound services in conjunction with primary care is one strategy to improve patient outcomes and reduce overall health care spending," Vest said.

Researchers estimated that wraparound services potentially saved $8.2 million from 2011 to 2016, based on median hospitalization costs. The estimate represents an average of $1.4 to $2.4 million potential cost savings per year.

Researchers calculated the potential savings by estimating the number of hospitalizations that could have been expected among those receiving wraparound services had the services not been offered.

"Early intervention and effective chronic disease management are vital to keeping people out of the hospital and reducing the burden of illness on the patient and on the health care system," said Dr. Lisa Harris, CEO of Eskenazi Health. "We know, based on our research, that our best opportunity to improve the lives of our patients and, by extension, the health and vitality of our community lies in helping individuals stay well."

In 2011, Eskenazi Health began employing various providers of wraparound services including behavioral health, social work, dietetics, respiratory therapy for asthma education, patient navigation, pharmacist education, financial counseling and a medical-legal partnership.

Wraparound services were also associated with a 5 percent reduction in the number of emergency department visits in the year after the services were provided. Researchers did not estimate potential cost savings for emergency department visits because emergency department costs were not available.

"Given that health and health care use are largely driven by social situations, environmental context and individual behavior, we believe that addressing these issues holds great promise for reducing costs and improving health outcomes," Halverson said.

"Historically, the health care system has not addressed these drivers of health and health care costs," Halverson said.

All patients in the study received at least one wraparound service. Counseling from a dietitian was the most common wraparound service, at 49 percent, followed by consultation with a social worker at 29 percent and behavioral health at 10 percent.

Given that wraparound services were co-located with primary care, caution must be taken in generalizing the study's findings to settings that rely on referrals to outside social service providers, the researchers said.
-end-
The paper, "Indianapolis Provider's Use of Wraparound Services Associated with Reduced Hospitalizations and Emergency Department Visits," was published in the journal Health Affairs. Additional authors are Dawn Haut, CEO of Eskenazi Health Center and an associate professor of clinical pediatrics at the Indiana University School of Medicine; and Nir Menachemi, professor of health policy and management and chair of the Department of Health Policy and Management at the Fairbanks School of Public Health.

Indiana University

Related Public Health Articles:

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.
BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.
The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.
Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.
Bloomberg American Health Initiative releases special public health reports supplement
With US life expectancy now on the decline for two consecutive years, the Bloomberg American Health Initiative is releasing a supplement to Public Health Reports, the scholarly journal of the US Surgeon General.
Data does the heavy lifting: Encouraging new public health approaches to promote the health benefits of muscle-strengthening exercise (MSE)
According to a new study in the American Journal of Preventive Medicine, almost 75 percent of US adults do not comply with public health guidelines recommending two or more muscle-strengthening exercise (MSE) sessions a week, with nearly 60 percent of the population doing no MSE at all.
The Lancet Public Health: Moderate carbohydrate intake may be best for health
Low-carb diets that replace carbohydrates with proteins and fats from plant sources associated with lower risk of mortality compared to those that replace carbohydrates with proteins and fat from animal sources.
Mass. public safety, public health agencies collaborate to address the opioid epidemic
A new study shows that public health and public safety agencies established local, collaborative programs in Massachusetts to connect overdose survivors and their personal networks with addiction treatment, harm reduction, and other community support services following a non-fatal overdose.
Cyber attacks can threaten public health
Gordon and Landman have authored a Perspective piece in the New England Journal of Medicine that addresses the growing threat of attacks on information systems and the potential implications on public health.
Public health guidelines aim to lower health risks of cannabis use
Canada's Lower-Risk Cannabis Use Guidelines, released today with the endorsement of key medical and public health organizations, provide 10 science-based recommendations to enable cannabis users to reduce their health risks.
More Public Health News and Public Health Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Uncharted
There's so much we've yet to explore–from outer space to the deep ocean to our own brains. This hour, Manoush goes on a journey through those uncharted places, led by TED Science Curator David Biello.
Now Playing: Science for the People

#556 The Power of Friendship
It's 2020 and times are tough. Maybe some of us are learning about social distancing the hard way. Maybe we just are all a little anxious. No matter what, we could probably use a friend. But what is a friend, exactly? And why do we need them so much? This week host Bethany Brookshire speaks with Lydia Denworth, author of the new book "Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond". This episode is hosted by Bethany Brookshire, science writer from Science News.
Now Playing: Radiolab

Dispatch 1: Numbers
In a recent Radiolab group huddle, with coronavirus unraveling around us, the team found themselves grappling with all the numbers connected to COVID-19. Our new found 6 foot bubbles of personal space. Three percent mortality rate (or 1, or 2, or 4). 7,000 cases (now, much much more). So in the wake of that meeting, we reflect on the onslaught of numbers - what they reveal, and what they hide.  Support Radiolab today at Radiolab.org/donate.