(Modern Healthcare) A mobile healthcare pilot could act as a roadmap for states looking to improve medical access in rural communities and for providers looking to increase revenues.
Twenty-two states included mobile medical units in their plans for how to spend part of $50 billion in Rural Healthcare Transformation Program funds. To qualify for the money, the Centers for Medicare and Medicaid Services required states to find ways to expand access to care in underserved areas through innovation.
A five-year federal pilot delivering services such as hospital-at-home, oncology and obstetrics through clinics on wheels could be a way to do that. Those are high-demand specialities in many rural communities and are reimbursed at a higher rate than other services, such as primary care.
Mobile medicine isn’t new — the concept has been around for decades. Most of the 3,600 mobile health vehicles in service nationwide offer services such as primary care, health assessments and vaccinations, according to the Mobile Healthcare Association, a trade group representing vendors, health systems and nonprofit groups.
Sustaining mobile medical programs has been a challenge. Some fail because they don’t offer services that enough people want. Many are funded through charitable grants and don’t seek reimbursement for services from government or private insurers, said Donald Blanchon, co-founder of Driving Health Forward, a mobile healthcare advocacy group.
Programs going after the federal funds to launch mobile healthcare need programs that are self-sustaining or profitable, he said. The Health and Human Services Department’s pilot could act as a guide.
Atrium Health, Huntsman Cancer Institute and Homeward Health will hit the road later this year using high-tech mobile medical clinics to deliver care to patients in rural North Carolina, Utah and Minnesota.
Atrium is partnering with Boston-based Ariadne Labs to deliver hospital-at-home and oncology services to patients within 100 miles of its base in Charlotte, North Carolina. The mobile hubs will be the size of recreational vehicles. They’ll be equipped with imaging equipment, laboratories, pharmacies, as well as broadband and satellite hardware to support telehealth.
Cancer patients can receive infusions in the vans and stay for observation. Hospital-at-home patients can receive telehealth and other services. Clinicians can also use the vans as hubs to deliver medication and services to patients at home.
Salt Lake City-based Huntsman Cancer Institute — part of University of Utah Health — will offer oncology services to cancer patients in three Utah counties. It hopes to expand the services throughout Utah, Nevada, Idaho, Wyoming and Nevada.
San Francisco-based Homeward Health will offer obstetrics and advanced wound care services to rural patients in Minnesota through partnerships with some health systems still to be identified. The company’s mobile clinic will include ultrasound equipment, a laboratory and other technologies typically found in hospitals.
Homeward Health partners with healthcare providers and insurers to provide in-home and telehealth services to rural patients in Minnesota and Michigan.
HHS is awarding $241 million over five years for the pilot. The goal is for the efforts to become profitable within a few years, said Homeward Health Co-founder and President Amar Kendale. He said that objective required providers to think carefully about the services they offered and the logistics.
“The path to financial sustainability is that [the vehicle] is never idle,” Kendale said. “Part of it is, yes, you can move the location. The other part of it is you have to choose clinical areas and procedures that have high enough volumes that you can always expect to have your lights on.”
Another aim of the pilot is bringing down the overall cost of the mobile clinics. Mobile medical vehicles can cost up to $1 million depending on size and the technology included, Blanchon said. Broadband and satellite hardware can add several thousand dollars to a vehicle’s cost.
“The goal is that by the end of the project, the van will cost $250,000. That is an enormous challenge. That will require manufacturing improvements and efficiencies of scale,” said Dr. David Levine, director of Ariadne Labs’ Home Hospital Program.
It could take a couple of years for the pilot to prove the various mobile health uses are cost-effective and potentially profitable to providers offering services in rural communities.
CMS is disbursing Rural Healthcare Transformation Program funds to states annually over five years. That could give programs time to assess the pilot and determine if they can deliver mobile healthcare profitably using similar strategies.
