Dramatic ROI could make mobile clinics a health reform standout

Exactly which post-reform healthcare payment models eventually will rule supreme in government and private sectors is still to be determined. But it's fairly obvious at this point that preventive care will be a critical service. Hospitals and health systems that are primary players in, for example, accountable care organizations or some type of global payment system will need to find new ways to provide healthcare services to a growing number of insured patients, preferably outside the costly hospital doors. Mobile clinics could be one of the tools that help healthcare providers offer cost-effective, efficient preventive care to patients.

Last year a nonprofit mobile clinic serving the Roxbury neighborhood of Boston saved the healthcare system approximately $20 million--on a budget of $500,000, reports Newsweek. The Harvard Medical School-affiliated mobile clinic (called the Family Van) has published data estimating a return on investment (ROI) of 36:1 ($36 saved in avoided emergency room visits and other pricey healthcare services for every dollar invested).

Ten other mobile clinics nationwide have produced a 20:1 ROI, according to the Harvard-developed algorithm. While falling short of the Family Van, that result still dwarfs traditional prevention programs, which Newsweek says typically have an ROI in the 3:1 range.

Mobile clinics aren't a new concept, but the success of the Family Van is particularly inspiring given that it doesn't fit into the conventional picture of the battered van of volunteers helping the uninsured masses. Massachusetts already has an individual mandate requiring residents to have health insurance, so 82 percent of the mobile clinic's patients have health coverage. In addition, more than half have primary care clinicians.

Many Family Van patients choose to use the service because it's in the neighborhood, accepts walk-ins and doesn't charge co-pays. In other words, it's convenient and free, so patients show up routinely for blood-pressure monitoring and other preventive care. The mobile clinic keeps costs low by using tried-and-true portable screening tools for high-cost conditions such as diabetes, obesity and hypertension. In addition, the Family Van doesn't employ physicians. Its clinicians are trained to provide specific preventive services and to make referrals.

To learn more:
- read this Newsweek article
- learn about the Harvard ROI calculator for mobile health services here

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