Social support services such as transportation can help lower healthcare costs and usage while improving outcomes, suggests a study published Monday in Health Affairs.
To provide better care for individuals, better health for populations and lower per-capita costs--the Triple Aim identified by the Institute of Healthcare Improvement--the healthcare system will need to include social support services, the researchers contend.
Such services, including emotional support for patients and their caregivers, transportation, and legal assistance, play key roles in both inpatient and primary care, according to the study.
"Unfortunately, fragmentation presents a major barrier to integrating the health care delivery and social service system," the study states. "The two systems operate with separate funding streams, different delivery vehicles and eligibility rules, varying training programs and expectations, and differences in terminology that hamper communication."
The study cited several examples in which integrated social support improved outcomes and cut costs, including:
A Vermont program cut the use of inpatient services by 21 percent year-over-year.
A program for older patients with chronic conditions and disabilities saw a 45 percent reduction in hospital days per 1,000 members among patients receiving social support.
Hospital use among high-risk patients in a comprehensive care program declined 20 percent over two years.
Annual hospital readmission rates fell 17 percent year-over-year among high-risk patients in one program providing coordinated care.
Diabetes patients in a special support program had a 21 percent lower hospitalization rate than comparable patients.
More research is required to determine which social service interventions most help specific patient populations, the researchers said. Developing that understanding could significantly benefit patients and the entire healthcare system, they concluded.
With that in mind, then-Sen. John Kerry (D-Mass) and Rep. Allyson Schwartz (D-Pa.) introduced legislation last year to improve the Older Americans Act through coordination between healthcare providers and organizations providing social support to seniors.
The legislation was withdrawn with Kerry's departure from the Senate for the State Department, but Schwartz plans to reintroduce the Care Coordination for Older Americans Act once she finds a new Senate sponsor, a spokeswoman from her office told FierceHealthcare. A number of senators have expressed support for the bill, she said.