Longwoods Blog

Calculating the return on investment of mobile healthcare

Nancy E Oriol, Paul J Cote, Anthony P Vavasis, Jennifer Bennet, Darien DeLorenzo, Philip Blanc and Isaac Kohane

Background: Mobile health clinics provide an alternative portal into the healthcare system for the
medically disenfranchised, that is, people who are underinsured, uninsured or who are otherwise
outside of mainstream healthcare due to issues of trust, language, immigration status or simply
location. Mobile health clinics as providers of last resort are an essential component of the
healthcare safety net providing prevention, screening, and appropriate triage into mainstream
services. Despite the face value of providing services to underserved populations, a focused analysis
of the relative value of the mobile health clinic model has not been elucidated. The question that
the return on investment algorithm has been designed to answer is: can the value of the services
provided by mobile health programs be quantified in terms of quality adjusted life years saved and
estimated emergency department expenditures avoided?
Methods: Using a sample mobile health clinic and published research that quantifies health
outcomes, we developed and tested an algorithm to calculate the return on investment of a typical
broad-service mobile health clinic: the relative value of mobile health clinic services = annual
projected emergency department costs avoided + value of potential life years saved from the
services provided. Return on investment ratio = the relative value of the mobile health clinic
services/annual cost to run the mobile health clinic.
Results: Based on service data provided by The Family Van for 2008 we calculated the annual cost
savings from preventing emergency room visits, $3,125,668 plus the relative value of providing 7 of
the top 25 priority prevention services during the same period, US$17,780,000 for a total annual
value of $20,339,968. Given that the annual cost to run the program was $567,700, the calculated
return on investment of The Family Van was 36:1.
Conclusion: By using published data that quantify the value of prevention practices and the value
of preventing unnecessary use of emergency departments, an empirical method was developed to
determine the value of a typical mobile health clinic. The Family Van, a mobile health clinic that has
been serving the medically disenfranchised of Boston for 16 years, was evaluated accordingly and
found to have return on investment of $36 for every $1 invested in the program.

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This entry was posted on Thursday, August 12th, 2010 at 4:05 pm and is filed under Longwoods Online.