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Recent changes to US reimbursement policies are increasingly holding providers financially accountable for patients’ health. Providing nonmedical services in conjunction with primary care—known as wraparound services—is one strategy to improve patient outcomes and reduce overall health care spending. These services leverage additional providers to address patients’ social determinants of health. Eskenazi Health—an Indianapolis, Indiana, safety-net provider—introduced wraparound services at its federally qualified health center sites. Behavioral health, social work, dietetics, patient navigation, and other services that address patients’ social and behavioral needs are co-located with primary care services. In an eleven-year panel of primary care patients, receipt of any wraparound service was negatively associated with subsequent hospitalizations and emergency department visits. The estimated cost savings from potentially avoided hospitalizations alone was $1.4 million annually. Under value-based payment, wraparound services may be one part of a portfolio of strategies to address the social, behavioral, and environmental factors that drive poor patient health and increase costs.
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