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Medical Legal Partnerships: Embedding Civil Legal Aid Services in Care for High-Utilizing Patients

An Effective Practice

Description

Lancaster General Health set up a super-utilizer pilot including a Medical-Legal Partnership. In addition to social workers, nurses, physicians, patient navigators, psychologists, and pharmacists, the pilot’s inter-professional team also included a lawyer from MidPenn Legal Services, the non-profit civil legal aid organization that serves South Central Pennsylvania. The pilot included 55 high-utilizing patients who were identified by frequent visits to the emergency room or inpatient services.

Goal / Mission

The goal of the pilot was to assess the impact on health care use of addressing patients’ civil legal problems – the social, financial, or environmental problems that require assistance from lawyers to remedy. The lawyer was embedded in the health care team and present during case management discussions to identify specific civil legal problems and to help the team better understand how to address them. Additionally, this partnership provided civil legal aid services to patients when needed in a community health care system.

Impact

This pilot shows a medical-legal partnership for the super-utilizers of healthcare can lead to efficiencies within the health care system, reduce costs, and improve health outcomes among the most vulnerable patients.

Results / Accomplishments

Of the 55 pilot patients, 95% (n=52) had two or more civil legal problems impacting their health care use. The pilot data suggest a decrease in both 30-day and 7-day readmission rates among identified patients. Both inpatient and ED use dropped more than 50%, and overall costs (as defined by charges) fell by 45%.

About this Promising Practice

Organization(s)
Care Connection: Lancaster General Health
Primary Contact
Jeffrey Martin, MD
555 N Duke St
Lancaster, PA 17604
717-544-3232
https://www.healthaffairs.org/do/10.1377/hblog2015...
Topics
Community / Governance
Health / Health Care Access & Quality
Community / Public Safety
Organization(s)
Care Connection: Lancaster General Health
Source
Health Affairs
Date of publication
4/22/2015
Date of implementation
Sep 2011
Geographic Type
Urban
Location
Lancaster, PA
Target Audience
Children, Teens, Adults, Families

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An Effective Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success and/or promise in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures of improvement in outcome of interest (i.e. increase in voter registration, not just delivery of voter registration drive) and/ or the outcome measure is increased or improved compared to the baseline measurement or the control group but the difference is not statistically significant.