Coordinated Care for Those Nearing Life's End — But Does It Save Money?

*Medical research has done wonders to rid populations of diseases; however, the U.S. health care system has failed to appropriate the right resources to Medicare patients with one or more chronic conditions. Health Quality Partners in Doylstown, PA enrolls Medicare patients with at least one chronic illness and hospitalization and sends a trained nurse to see them on a routine basis, whether they are healthy or sick. As a result, the HQP program has reduced hospitalizations and cut Medicare costs.

Doctors at Stanford University developed per-patient and per-month payment plans to better support patients with complex medical needs. The approach upends the typical per-service payment model. It has radically improved primary care by incentivizing healthcare providers to offer more comprehensive support.

Across the country, hospitals are embracing intensive intervention programs to help victims of violence — including those who have criminal histories — after they have been brought in for treatment of injuries. Such programs can help prevent retaliation, reduce the chance a patient will be violently injured again, and put people on track for success.

A program called the Safety Planning Intervention is reducing the occurrence of repeat suicide attempts among veterans. The program helps veterans establish a safety plan and identify a support network that they can rely on during times of crisis.

After a brutal incident led to a violent attack and the death of his son, Senator Creigh Deeds was determined to reform the mental health system in Virginia. The Deeds commission passed a series of reforms, among them a law that created a registry of open psychiatric beds, a transportation program so that people don’t have to be detained by police, and a program that offers housing for people with mental illness.

Hospitals in Colorado are changing their approach to opioid crisis by treating patients that come in as emergent cases and rushing them into medication-assisted addiction treatment. The model has proved so successful that doctors are now looking to expand this approach to methamphetamine users as well.

Harm reduction is a quickly growing practices that aims to reduce drug-related deaths and the spread of disease often caused by dirty needles. Although public perception is still widely negative, the industry has seen success by using the act of offering clean needles as a first point of contact to offer other health and medical services.

To help address the shortage of personal protective equipment in hospitals, companies and individuals in the fashion industry are turning from clothing production to face mask production. This approach, which is being implemented across the U.S. and Europe, not only helps the medical industry, but also helps to keep those in the fashion industry employed during the pandemic.

The Wraparound Project at Zuckerman San Francisco General Hospital and Trauma Center turns gunshot victims' hospital stays into "a teachable moment," by providing them with services aimed at helping them avoid a repeat injury. Getting shot once is a key risk factor for a second injury, particularly for gun violence's most common victims, young Black men. Wraparound is one of the nation's oldest hospital-based violence intervention programs. It has helped about 850 clients, mostly with mental health counseling, housing, and jobs. The program is associated with a decreased reinjury rate in San Francisco.

Doulas are becoming a more widely used resource among pregnant people, particularly Black women who historically face racial inequities during pregnancy and childbirth. Groups like The Doula Network and the Southern Birth Justice Network are working to expand doula services by training and connecting pregnant women with certified doulas. Doula care is more holistic and studies show that women using doulas have about a 65% reduction in their odds of developing postpartum depression or anxiety when a doula is present during labor and delivery.