Hospitals are looking at providing homeless and uninsured patients services such as mobile medical homes to reduce their use of expensive emergency department care.
In Delaware, for example, Wilmington's St. Francis Healthcare sends a medical van into underserved communities to offer free primary care services, reports the News Journal. For Christiana Care Health System, the solution is its Medical Home Without Walls, which visits uninsured patients in homeless shelters or on the streets, among other locations, and can even accompany patients on provider visits.
The medical home targets "super users" who account for more than 20 percent of hospital visits, program medical director Diane Bohner, M.D., told the News Journal. The hospital's electronic record system flags uninsured patients admitted twice in six months, and uninsured patients who visited the ED four times in six months. A team including a social worker and a nurse practitioner help coordinate care for patients, the newspaper reported.
Meanwhile, in Largo, Fla., Pinellas County is using a $5 million federal grant to build a health clinic aimed at homeless families, the Tampa Bay Times reported. Baycare and All Children's Hospital are expected to provide medical staff.
County officials told the Times that homeless families often forego primary care treatment for their children out of fear doctors will turn them in to the Department of Children and Families, the local social-services agency.
With care coordination issues also affecting readmission rates, potentially leading to costly Medicare penalties, post-discharge recuperative centers are lauded as a way to give homeless patients an alternative to being discharged to the streets or homeless shelters.