roi for mobile outreach clinic nancy hardt, md brian mcdaniel ms2 jack stacey (ruum)
TRANSCRIPT
ROI for Mobile Outreach Clinic
Nancy Hardt, MDBrian McDaniel MS2Jack Stacey (RUUM)
Mobile Outreach Clinic
Measuring Return on Investment
Local Solution
The University of Florida launched the Mobile Outreach Clinic in January of 2010
Stops 6 at-risk neighborhoods around Alachua County
Mobile ClinicServices & Budget• Health Screenings• Primary Care for Men, Women &
children• Well Women Check ups• Family Planning• Resources and Referrals
Harvard Study Mobile Health Map
Mobile Outreach Clinic
Budget $334k $567k $250k# of Visits/year 3702 3100 4500Value 1:35 1:19 1:34
ED & QALYS only ED & QALYS only ED & Births only
2010 2011 2012 2013-Projected; based on Q1
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Number of Visits
Number of Unique Pa-tients
Mobile ClinicNumber of Clinic Visits vs. Unique Patients
Mobile ClinicImpact on Costs to Area Hospitals & Taxpayer
Measured Impact• Emergency Room Visits•Medicaid Births
Un-Measured Impact• Strokes• Asthma Attacks• Diabetic Complications• STDs detected/treated
Number of Alachua County Emergency Department Visits by Payer 2005-2010
2005 2006 2007 2008 2009 20107000
9000
11000
13000
15000
17000
19000
21000
Self-Pay/No Payment
Private
Medicaid
Medicare
“Have you ever had to go to the Emergency Room because you
could not be seen by another doctor or
clinic?”
Yes41% No
59%
n = 431
UF MOBILE CLINIC SURVEY
“If the Mobile Outreach Clinic did NOT exist, how likely would you be to go to the Emergency Room for your current health issue?”
Very Likely29%
Very Unlikely
37%
14%Somewhat
Likely10%
Neutral
10%Somewhat
Unlikely
n = 431
For those patients that had visited the Mobile Outreach Clinic at least once in the last 6 months, “Have you made less visits to the Emergency Room in the last 6 months because of the Mobile Outreach Clinic?”
Yes53%
No47%
n = 288
Prevented Emergency Department Visits= (% of patients that answered “Very Likely”)*(Total Yearly MOC Patient Visits)= (29%)*(4600) = 1334 visits
Prevented Emergency Department Expenditure = (1334)*(cost per self pay ED visit) = (1334)*(3713) = 4,953,142 dollars per year
Return on Investment (ROI) FOR ED ONLY= = (4.95 million) / (MOC yearly budget) = (4,953,142) / (250,000) = $19.81
Florida Medicaid Births
106,220 taxpayer funded births in 2011 (Florida Charts, 2013)
62.9% of all taxpayer funded births in Florida were unintended in 2011
(Sonfield, 2011)
The Consequences
In 2006, unintended pregnancies in
Florida cost taxpayers $641.5
million (Sonfield, 2011).
Study Design: COMPARE Alachua County vs. State of Florida
Comparison
– Total birth count
– Total births paid by Medicaid
–Percentage of births paid by Medicaid
Data Sources
Florida Charts
FDOH
UF Family Data Center
Comparing Alachua Co To FL: Birth Count
2007 2008 2009 2010 2011 2012
5,200
5,400
5,600
5,800
6,000
6,200
6,400
6,600
Alachua County
2007 2008 2009 2010 2011 2012
200,000205,000210,000215,000220,000225,000230,000235,000240,000
Florida
Comparison between Alachua County and FL: Births Paid by Medicaid
2007 2008 2009 2010 2011 2012
2,700
2,900
3,100
3,300
3,500Alachua County
2007 2008 2009 2010 2011 2012
98,000100,000102,000104,000106,000108,000110,000
Florida
Percentage of Births Paid by Medicaid
20072008
20092010
20112012
40
42
44
46
48
50
52
54
56
Florida
Alachua County
Birth Density
Before Mobile Outreach Clinic
After Mobile Outreach Clinic
Cost Effectiveness
• The average Medicaid birth in Gainesville from 2007 through 2009 was $20,900 (Family Data Center, 2011)
• The clinic budget is approximately $250,000 per year• This is the same cost as 12 Medicaid funded births• In actuality, there were 94 less Medicaid births in Alachua
County in 2011 than 2010 which saved taxpayers $1,964,000 (7.856/1)
• In the following year, 2012, there were 175 fewer Medicaid funded births which amounted to $3,657,000 in savings (14.628/1)
ROI
• $3,657,000+ $4,953,142=$8,610,142• $8,610,142/$250,000=34.44• $19.81 (ED) plus $14.63(births)= $34.44/$1 invested• NOT COUNTING averted hospitalizations, averted heart
attacks, averted strokes