Nation’s First Health Impact Bond Launched in Fresno

A team of nonprofit organizations is piloting a new social impact bond targeting the prevention of asthma in Fresno, California, according to a report from Reuters.

The effort teams Clinica Sierra Vista, a Fresno-based nonprofit, Collective Health, a pioneer in health impact bonds, the Central California Asthma Coalition, and the California Endowment, a foundation that is providing “hundreds of thousands” of dollars in financing.

The project will work with 1,100 low-income asthma patients, educating them to take action against asthma triggers in the home by using interventions reviewed by the Centers for Disease Control and Prevention. The goal is an improvement in health outcomes and a 30 percent to 40 percent in savings per person per year on emergency visits and other costs. Asthma causes emergency room visits, hospitalizations, generating about $15,000 in expenses each year. The team hopes to bring that down to $9,870.

Kevin Hamilton, deputy chief of programs for Clinica Sierra Vista, told KVPR, a local Fresno radio station:

“We’ll also be doing an in-home assessment, to determine what kind of housing they live in are there problems in the house like old carpets that are full of dust, is there a mold problem, asthma-safe cleaning solvents and things like that, are the families using that, do they have access to those kinds of things, do they have a vacuum cleaner with a HEPA filter, all of those sorts of things will be assessed. And wherever there are things that could be corrected  this project will be supplying us with money to do that. We have approximately $1,000 to spend on each household.”

According to a backgrounder on the Fresno project by Collective Health, the pilot has significant scale-up possibilities:

Fresno County has an estimated 200,000 individuals living with asthma, who each year account for more than 6,000 emergency room visits and 1,100 hospitalizations, plus follow-up care and doctor office visits. When lost worker productivity is included, the annual cost of asthma in Fresno totals $87 million.

According to a separate paper on health impact bonds by Collective Health, there are national implications, too. “Health spending in the U.S. approached $2.6 trillion in 2010, with 12% of all workers employed in some aspect of the health care industry.”

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