Partnerships with harm reduction centers cut hospital readmissions

Harm reduction centers that distribute needles and condoms in at-risk communities can help hospitals deliver person-centered care to vulnerable patient populations and ultimately reduce readmissions, according to a new report.

Partnerships with these centers are a logical way for hospitals to improve care-coordination efforts, according to the report from the New York Academy of Medicine, "The Integration of Harm Reduction and Healthcare: Implications and Lessons for Healthcare Reform."

Such partnerships are able to "coordinate complementary services and improve access for people with the greatest need for comprehensive care," the report noted. These arrangements can take various forms, including:

  • Teaching hospitals establishing part-time clinic hours at harm reduction centers
  • Larger healthcare organizations coordinating and co-locating clinical and harm reduction services
  • Hospitals placing clinical and pharmacy services at a harm reduction center

A case study accompanying the main report looked at how BOOM!Health in New York City combined harm reduction services with on-site primary care, mental health services, drug-addiction treatment and pharmacy services, as well as food and nutrition counseling and legal aid services.

The integrated health clinic would have struggled to survive, BOOM!Health president Robert Cordero said in an interview with Kaiser Health News. Healthcare reform makes it easier for the partnerships to get Medicaid funding at levels high enough to sustain coordinated programs, Cordero said, echoing the report's findings.

BOOM!Health receives Medicaid funding through managed care organizations at hospitals including the Bronx-Lebanon Hospital Center, he told KHN. Hospitals pay a "per member, per month" rate. Medicaid assigns patients with two or more conditions to the hospitals, which must be able to demonstrate outcomes, he said.

Medicaid expansion in New York provided the clinic with enough additional revenue to invest in health IT systems, which enables better documentation of outcomes, he said.

The partnerships form as hospitals are increasingly under scrutiny for discharging homeless patients into situations that will likely lead to readmissions. Many cities have created "respite care centers" where social-services groups can connect discharged patients with food, housing and other services.

In other cases, hospitals send medical vans into communities to provide free primary-care services for homeless patients or take patients to see a doctor before they need emergency care or hospital admission.

For more:
- here's the report (.pdf)
- read the case study (.pdf)
- read the KHN article