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Project aims to reduce emergency room "frequent fliers" by tackling underlying social issues

Oct 31, 2016

The Next Idea

Take funding from the Affordable Care Act, add a $70 million state innovation model grant to the state Department of Health and Human Services, and you’re about to see an ambitious new project that can change health care delivery in Michigan.

It’s called Michigan’s Blueprint for Health Innovation.

Dr. Paul Valenstein is the co-chair of the effort in Washtenaw and Livingston counties, one of five “community innovation” regions where this three-year project will launch next January.

Valenstein told us that the goal is to improve care for patients with both social and medical health needs by better connecting social care agencies with the health care system.

“We’re focusing first on patients who go to the Emergency Room frequently,” he said.

According to Valenstein, the University of Michigan Health System reports around 600 people who show up in their emergency room five or more times in a year. The St. Joseph Mercy Health System reports another 600 such patients.

"We're using a very expensive resource, the emergency department, for problems that we really think of as social problems."

“Almost nobody is so unlucky as to have five accidents that require them to go to the emergency department in a year,” he said. “Something’s going on.”

He told us that when you look at these patients’ records, some patterns start to emerge.

“Some of them have substance abuse problems.… Many of them have mental health problems. Some of them are homeless. Some are hungry,” he said.

“We’re using a very expensive resource, the emergency department, for problems that we really think of as social problems,” Valenstein said. “This is a very high-priced resource. It wasn’t really designed to address social issues.”

Aubrey Patino is from the Frequent Users Systems Engagement Initiative, led by Avalon Housing. FUSE is one of the agencies that will be part of Michigan’s Blueprint for Health Innovation.

She told us FUSE targets those who frequently utilize emergency health systems, are homeless and have chronic health conditions. FUSE provides these individuals with supportive housing using a “housing-first approach, which treats housing as a basic human right, not a reward for clinical success,” she said.

"We have to address that social determinant of health, that issue of housing instability, before we can expect that they'll be able to manage their complex medical needs."

“We couple that sort of using housing as a foundation for recovery with pretty robust wraparound supports where we follow people into the community and provide care coordination to them.”

She told us that people who frequently lean on emergency health services not only cost the broader health care system a tremendous amount of money, they also see their quality of life suffer as a result.

“When you compound that with the experience of homelessness, we know that we have to address that social determinant of health, that issue of housing instability, before we can expect that they’ll be able to manage their complex medical needs,” Patino said.

Listen to our conversation below for more from Dr. Paul Valenstein and Aubrey Patino about the upcoming project, Michigan’s Blueprint for Health Innovation.

 

The Next Idea is Michigan Radio’s project devoted to new innovations and ideas that will change our state.

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