HS-42 Integrating Legal Aid with Healthcare: Evaluating the Impact of Medical-Legal Partnerships on Utilization and Costs

Background Medical-Legal Partnerships (MLPs) integrate legal aid with healthcare to address social determinants of health, such as housing instability and access to benefits, that negatively affect health outcomes. MLPs aim to improve patient health, reduce unnecessary healthcare utilization, and optimize resources by addressing health-harming legal needs. Previous studies show MLPs can reduce hospital visits, improve treatment compliance, and enhance preventive care use. This study evaluates the impact of MLPs on healthcare utilization and costs among patients referred to the Upstate MLP program. Methods The Upstate MLP, a partnership between Prisma Health, South Carolina Legal Services, and Furman University, analyzed Medicaid claims data from 263 clients (2018–2022) to assess healthcare utilization and costs before, during, and after MLP interventions. Summary statistics and one-way ANOVA were used for analysis. To support the research, data cleaning and standardization were performed on a REDCap database containing approximately 1,000 patients and variables, with referrals categorized using the I-HELP framework. Prisma Health provided encounter-level data, including charges and reimbursements, for these patients. The cleaned data were matched with healthcare utilization and claims data to evaluate the relationship between legal interventions and healthcare outcomes. Results Pediatric patients (n=235) experienced an average reduction of $180 per outpatient visit, with emergency room visits (n=133) and inpatient visits decreasing by 3% and 4%, respectively. Geriatric patients (n=28) saw monthly outpatient cost reductions of $805.07, while emergency room visits (n=16) dropped by 7%. However, inpatient visits for geriatric patients increased by 7%, highlighting the complexity of care needs in older populations. Discussion The findings suggest MLPs can reduce healthcare costs and improve outcomes, particularly for pediatric populations. Cost reductions in outpatient visits reflect improved health condition management, while mixed results for geriatric patients emphasize the need for targeted interventions. Continued analyses of approximately 1,000 MLP-referred patients are underway to evaluate long-term outcomes and healthcare utilization patterns. These efforts aim to enhance understanding of MLPs’ value in addressing social determinants of health, improving care quality, and informing healthcare policy to promote equity and efficiency.