Enabling services improve health outcomes, study finds

Patients who receive enabling services are more likely to visit a health center, get a routine health checkup, receive a flu shot, and be satisfied with their medical care, according to a new study published in Health Affairs.

Enabling services—which include care coordination, health education, transportation, and help with food, shelter, and benefits—aim to reduce health disparities by addressing the social determinants of health and healthcare access barriers.

For the study, researchers looked at how the receipt of enabling services influenced patient healthcare outcomes based on a national survey of patients served in 2014 at health centers funded by the Health Resources and Services Administration. Specifically, they compared patient data for enabling services users and nonusers who participated in the survey.

The results showed that enabling services users had 1.92 more heath center visits over a 12-month period. Additionally, patients who received enabling services were 11.78% more likely to get a routine checkup and 16.34% more likely to receive a flu shot. Enabling services patients were also 7.63% more likely to report higher levels of patient satisfaction.

“We found data that support the notion that providing any or a mix of enabling services to address barriers to access and social determinants of health improves patients’ use of primary and preventive care, as well as their satisfaction with care received,” the researchers wrote.

Among the patients who received enabling services, care coordination (54.7%) was the most common, followed by health education (28.6%), free medication (27.1%), government benefits assistance (24.3%), and supportive counseling (15.5%).

Citing the benefits of enabling services, the researchers recommended more funding, including from private health insurers. “As the U.S. health system increasingly focuses on value-based care delivery, reliable funding for enabling services can be explicitly included,” they said. “Designing a sustainable model for delivering enabling services, especially in low-income populations, would ensure the delivery of these services and could improve the health of these populations.”