More than five million people in the United States have an intellectual or developmental disability. While many live relatively independently and with few supports, a portion of them have medical complexities and behavioral challenges that require higher levels of care. Despite advances in medicine and the fact that this population is largely insured, disparities in access to health care and in health outcomes remain — especially for the 35% who have a mental health diagnosis and an increased risk of multiple chronic diseases.
Over the last year, Woods Services, which provides comprehensive population health services for people with intellectual or developmental disability and complex medical and behavioral needs, conducted a patient-centered medical home pilot program in partnership with Pennsylvania’s largest Medicaid insurer, Keystone First. Medical homes coordinate care through increased use of primary and preventive care. The idea behind the pilot program was to see whether they would reduce overall health care costs and improve health outcomes.
The results are in. Over the past year, while primary care visits increased, inpatient hospitalization costs decreased 39%, emergency room costs dropped 2.3%, and total costs went down 8.7%. “Gaps in care,” i.e. visits or screenings not conducted as standards of care recommend, especially for those with chronic diseases, were also reduced. These are exceptional results.
It is clear that innovations such as this can dramatically improve quality and access to health care for people with intellectual or developmental disability and complex medical needs. The next step is for providers to put them into practice.