Health Care Systems Try to Cut Costs by Aiding the Poor and Troubled

Key Questions Answered
  • What are some promising ways to rethink health care for people with the highest need, to help them face the everyday challenges of poverty?
  • What is the evidence for cost savings of this more holistic approach?
Key Themes and Takeaways

This resource describes experiments to reinvent health care for Medicaid patients who are especially difficult to help due to poverty.

  • More than 11 million Americans have joined the Medicaid rolls since the major provisions of the Affordable Care Act took effect.
  • Experiments across the country are trying to address the challenges of poverty as well as medical needs in order to avoid expensive emergency room visits. Health outreach workers perform services such as giving patients essential items (for example, bus tickets and blankets), handling eviction notices, and shopping for groceries with diabetic patients.
  • In Hennepin County, Minnesota, a pilot program focuses on about 10,000 people who gained coverage when the state expanded Medicaid. It is paid for with state and federal Medicaid dollars and run by the county government and the safety-net hospital. The hospital, Hennepin County Medical Center, is paid a fixed amount per patient, which remains the same even if patients do not show up.
  • The program offers services such as helping people get phones and mailboxes, taking care of unpaid utility bills, and providing a place where inebriated patients can sober up.
  • Medical costs have fallen by an average of 11 percent per year since 2012 when the program began. Costs have improved especially among more than 250 patients who were placed into permanent housing.
Sabrina Tavernise
Population Addressed
People with Behavioral Health and Social Needs
Level of Evidence
Expert Opinion
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