CRUNCHING THE NUMBERS
Many say Oriol’s model of preventive care was ahead of its time. According to Professor of Health Care Policy Richard G. Frank, preventive services were emphasized less as health insurance came to dominate the American health care system.
Frank says that, in his own work for the Department of Health and Human Services from 2009 to 2011, he worked to reinstate the value of preventive care through the Affordable Care Act.
“Now that we have a better understanding about the course of illness and biological mechanisms, we can take a more sophisticated view of prevention,” Frank says. “As the science has evolved, the policy and the insurance are trying to catch up.”
In this vein, The Family Van has turned a critical eye toward the role of mobile medicine in a reformed health care system.
“We are trying to bring evidence of what we know to be true on the street,” Oriol says. “After 20 years of seeing thousands annually, we need to take our stories and turn them into data.”
The barriers to health care for The Family Van’s clients are substantial. In the last fiscal year, 87 percent of the Van’s 4,000 clients were minorities. Thirty-seven percent did not speak English. Thirty-one percent were unemployed.
Over the past six years, Research Program Director Caterina Hill has analyzed data to understand how the Family Van empowers clients to manage their health while controlling costs. The results, she says, “were shockingly good.”
One in three of the van’s clients discovered for the first time through screening that they had glaucoma or elevated blood pressure, glucose, or cholesterol. More than one in two regular clients who had high blood pressure during their first visit had it under control during their most recent visit.
Accounting for the value of emergency department visits avoided and quality life years saved for clients, Hill says the Family Van is worth over $11,000,000. She adds that the return on investment for the American health care system is $23 saved for every dollar spent on the Van.
The Family Van Executive Director Jennifer L. Bennet says the initiative provides a promising model at a time when controlling health care costs has become increasingly urgent.
“As an organization that relies on community health workers, the van is a cost-effective partner with neighborhood health centers to deliver heath education and monitor chronic disease,” she says.
FILLING IN THE GAPS
After attending the Mobile Health Clinics Annual Forum in 2006, Bennet discovered that The Family Van’s success had been shared by nearly 2,000 mobile clinics nationally and around the world.
She says mobile clinics have been implemented from China to Africa to Central America. In the Amazon, boats are even being used to deliver mobile health services.