An Analysis On The Financial And Health Access Return On Investment Of The University Of Minnesota's Mobile Health Initiative
Drew Adamek, Bhavana Goparaju, MS, Maggie Eckerstorfer, Opeyemi Adesida, MBBS, MPH, Shahid Jaffer, MD, Jonathan Kirsch, MD 8 March 2022
There are around 2000 mobile health clinics operating in the United States. These clinics provide over 6.5 million visits annually by traveling directly to areas of underserved communities and offering a variety of preventative services, all with the goal of advancing health equity (Malone, 2020). They also serve an economic benefit to the healthcare system, as aggregate data shows a national average of a $14 return on investment (ROI) per $1 invested in a mobile clinic based on statistical quality of life years (QALYs) saved as well as the prevention of emergency department visits for non-urgent care (Brown, 2013). However, there is little data regarding ROI during the developmental stages of mobile health units, particularly those focused on migrant health and operated in the setting of the COVID-19 pandemic. Thus, the goal of this study was to analyze the financial ROI and access-to-care ROI of the UMN Mobile Health Initiative during the events it held during the calendar year of 2021. Financial ROI was calculated through QALYs and ED/UC visits saved from preventative services (Oriol et al., 2009). Access-to-care ROI was determined by analyzing the ratio of elevated lab results to those within normal limits of those with and without prior medical histories as well as the number of total patients seen and services performed throughout the year. We found an overall positive ROI (2.92:1 to 40.42:1 depending on the type of costs analyzed), especially when considering our services as an add-on to existing structures (71.46:1 for A1C tests and 159.51:1 for HTN screenings) with a 7.03 total QALYs saved and a total value saved of $479,795 to $514,079 depending on the type of costs analyzed. We also found a high access-to-care ROI with a significant portion of individuals both with and without history of diabetes or hypertension having elevated lab values (59.5% total HTN screenings elevated; 51.9% total A1C screenings elevated or outside of goal), indicating unmanaged care. Based on these findings, we have made recommendations for new types of high-return screening services, a system of outcome-tracking, and a streamlined data collection process to be implemented in the future to allow for continued high rates of ROI for this program.