Patients who use 9-1-1 15 or more times in 90 days, or who are referred into the program by ED or payer case managers due to high ED utilization, are enrolled. MedStar’s Mobile Healthcare Providers (MHPs) conduct regular home visits, evaluate Social Determinants of Health, connect the patients to available resources and teach the patients how to better manage their own healthcare. Typical enrollment is 30-90 days. Since October 2013, 820 patients with 2 years of utilization data available (1 year pre and 1 year post enrollment) have reduced ambulance transports to the emergency department by 48.4%  It also has prevented 5,545 ED visits in this patient population. This reduction has saved $15 million in healthcare expenditures for ambulance and ED admissions ($18,297 per enrolled patient).

Patients at risk for a 30-day readmission are referred to MedStar by the patient’s Case Manager or PCP. MedStar conducts a series of home visits to educate the patient and family on appropriate care management and loops the patient to their PCP. If the patient needs intervention, the MedStar MHP may coordinate in-home diuresis or other treatments with the patient’s PCP, along with a follow-up PCP appointment. Since October 2013, 684 patients who had a prior 30-day readmission AND the referring agency felt would have a 30-day readmission have been referred into the program. The enrolled population had a 49.2% readmission rate versus the expected 100% readmission rate.

MedStar works with numerous healthcare partners with special populations to help navigate patients to the most appropriate source of care for their medical needs. Sometimes this is during a 911 call, while at other times it’s a home visit requested by the partner agency. These partners include hospitals, health insurers, home health and hospice agencies, care management organizations, accountable care organizations and other partners.  Through December 2023, of the 6,054 911 and urgent care responses to these enrolled patients, only 4,179 (69.0%) of the calls resulted in the patient being transported to an emergency department.

Patient Perception of Health Status

Patients enrolled in MedStar’s MIH programs are provided with a questionnaire to assess their perception of their health status upon enrollment in the program, and then upon graduation from the enrollment. These scores are then compared to assess how the patient’s perception of their health status has changed as a result of the enrollment.  The chart below depicts the EuroQol score or the change in the patient’s perception of their health status.