A new corps of trained Grand-Aides has the potential to extend reach of primary care workforce and save money

Health Affairs
Arthur GarsonChristopher Nye

Abstract

Because the Affordable Care Act will expand health insurance to cover an estimated thirty-two million additional people, new approaches are needed to expand the primary care workforce. One possible solution is Grand-Aides®, who are health care professionals operating under the direct supervision of nurses, and who are trained and equipped to conduct telephone consultations or make primary care home visits to patients who might otherwise be seen in emergency departments and clinics. We conducted pilot tests with Grand-Aides in two pediatric Medicaid settings: an urban federally qualified health center in Houston, Texas, and a semi-rural emergency department in Harrisonburg, Virginia. We estimated that Grand-Aides and their supervisors averted 62 percent of drop-in visits at the Houston clinic and would have eliminated 74 percent of emergency department visits at the Virginia test site. We calculated the cost of the Grand-Aides program to be $16.88 per encounter. That compares with current Medicaid payments of $200 per clinic visit in Houston and $175 per emergency department visit in Harrisonburg. In addition to reducing health care costs, Grand-Aides have the potential to make a substantial impact in reducing congestion in prim...Continue Reading

References

Nov 10, 2009·American Journal of Preventive Medicine·Matthew J O'BrienSteven C Larson

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Citations

Jan 15, 2016·The American Journal of Emergency Medicine·Robert G SolbergMichael D Williams
Mar 24, 2016·Healthcare : the Journal of Delivery Science and Innovation·Yana VaksArnold Milstein
Jun 9, 2016·Journal of Urban Health : Bulletin of the New York Academy of Medicine·Norma Alicea-AlvarezNora Jones
Nov 6, 2013·Health Affairs·Arthur L KellermannSiddartha Dalal
Oct 17, 2013·Academic Medicine : Journal of the Association of American Medical Colleges·Joel D Howell
Feb 6, 2017·BMC Family Practice·Edward H WagnerMaryJoan D Ladden
Jun 30, 2019·Clinical Pediatrics·Sagar M RajuEric W Fleegler
Nov 26, 2019·Journal of Nutrition in Gerontology and Geriatrics·Brenda Diane Bustillos, Joseph Richard Sharkey
Oct 17, 2013·Academic Medicine : Journal of the Association of American Medical Colleges·Arthur Garson
Oct 17, 2013·Academic Medicine : Journal of the Association of American Medical Colleges·Erin P FraherWarren P Newton
Dec 6, 2018·Health Services Insights·Stephen H LinderArthur Garson
Jan 11, 2021·The Gerontologist·Hayley P Gleason, Edward Alan Miller
Mar 4, 2015·Annals of Internal Medicine·Victor R Fuchs

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