Changes in healthcare utilization and costs following enrollment in an interprofessional primary care clinic designed to address clinical and social vulnerabilities

Meeting the needs of patients with substance use disorders (SUDs), complex comorbidity, and social determinants of poor health is challenging in traditional primary care environments. Interprofessional primary care (IPC) can better address these needs and may reduce acute care utilization and healthcare costs. We used a retrospective cohort study design (<i>n</i> = 994 patients) to compare healthcare utilization and costs 2 years before and after patients enrolled in an IPC model in the US Veterans Health Administration. Patients were grouped based on histories of high emergency department (ED) use, SUDs, homelessness, and combinations of these vulnerabilities. Generalized estimating equations (GEE) tested for differences in utilization and costs across groups. Following IPC enrollment, primary care visits and costs increased overall (adjusted increase = 2.90-7.24 visits/person-year; $1,032-$2,817/person-year). Among patients with prior high ED use, acute care costs declined; among patients without prior high ED use, acute care costs were mixed and ED use increased. Total costs decreased, were neutral, and increased for patients with 3, 1-2, and no vulnerabilities, respectively. Primary care engagement, reduced acute care, and limited cost increases suggest high value in this IPC model and highlight the need to further study IPC in addressing addiction and social determinants of poor health.