Project

Frequent Users of Health Services Initiative

Project Overview

The Frequent Users of Health Services Initiative was a five-year, $10-million joint project of The California Endowment and the California HealthCare Foundation. The Initiative focused on promoting a more responsive system of care that addresses patients' needs, improves outcomes, and decreases unnecessary use of emergency rooms and avoidable hospital stays.

"Frequent users" are often chronically ill, under- or uninsured individuals who repeatedly use emergency rooms and hospitals for medical crises that could be prevented with more appropriate ongoing care. They often have multiple psychosocial risk factors, such as mental illness, alcohol or substance use disorders, and homelessness, and they lack social supports, which affects their ability to get continuous, coordinated care.

The Initiative supported innovative approaches that addressed frequent user patients' multiple needs -- for example, medical, mental health, housing, alcohol or substance abuse treatment -- through multidisciplinary care, data sharing, adoption of best practices, and engagement of patients in the most appropriate setting. The foundations created the Initiative to encourage such approaches and stimulate the development of a cost-effective, comprehensive, and coordinated delivery system for health and social services.

The Initiative funded six demonstration projects across California that emphasized integrated strategies to meet the health and related needs of the frequent user population. Pilot programs were located in Alameda, Los Angeles, Sacramento, Santa Clara, Santa Cruz, and Tulare Counties. Ultimately, the Initiative aimed to relieve pressure on overburdened medical systems and to promote more effective use of resources.

The evaluation of the initiative conducted by The Lewin Group, an independent health care policy research and management consulting firm, showed that multi-disciplinary, coordinated care can reduce hospital visits and costs, while helping to improve stability and quality of life for patients. The results included a 61% decrease in emergency department visits and a 62% decrease in hospital inpatient days for clients enrolled in the programs for two years. For those clients on Medi-Cal at enrollment, ED visits decreased by 60% and inpatient days decreased by 69% after two years in the programs.

The ten-minute video below highlights a few success stories of one of the grants, Project Connect in Santa Cruz County.

The Initiative was managed by the Corporation for Supportive Housing's California office in Oakland, which continues to focus on this issue. The lessons learned by the Initiative pilot programs are summarized in the toolkit, Meeting the Needs of Frequent Users: Building Blocks for Success. The toolkit has been designed for communities interested in replicating the successes of the Initiative pilot programs.

To learn more about the Initiative, the toolkit, and the evaluation results, visit the Frequent Users of Health Services Initiative Web site through the link below.