Vermont's Approach to Primary Care Is Driving Down Costs

Modeled after a similar program in Costa Rica, Neighborhood Nursing has teams of nurses and community health workers who host weekly visits throughout the community to provide free medical care — particularly preventative care — to those who need it. Neighborhood Nursing has helped build trust between residents and healthcare workers and aims to serve more than 4,000 people within the next year.

After sudden U.S. government funding cuts jeopardized South Africa's HIV programs, Limpopo's Hlokomela Clinic quickly reorganized around existing resources, training community health workers to identify and encourage farm workers to visit still-operational clinic sites for HIV testing. By leveraging volunteers, they partially offset the impact of losing their dedicated HIV testing outreach team and program funding.

The Boresha afya ya mama na mtoto (improve the health of mother and child) program works to reduce maternal and infant mortality rates by connecting mothers with community health volunteers. These volunteers provide important education on topics like antenatal care and also help to increase access to immunization services. When the group formed in 2018, 531 women died during childbirth or pregnancy, but as of 2023, that number has dropped to 344 thanks to the program’s initiatives.

Care Ring, in collaboration with other organizations like the University of North Carolina School of Nursing, launched The Bridge, a community-based healthcare initiative that aims to make preventive care easier to access. The Bridge features a mobile care unit that provides free health screenings, counseling support and connections to community resources. Since December 2022, The Bridge has provided care to more than 100 people, 39% of which didn’t have a regular doctor.

The Mobile Integrated Healthcare program follows a practice known as community paramedicine, allowing paramedics to use their skills to care for patients outside of emergency settings, reducing the need for excessive ER visits, lowering healthcare costs and increasing access to care. Similar programs have emerged throughout the country, seeing a significant decrease in the number of ambulance rides and ER visits.

The Atayese initiative makes healthcare services more affordable and accessible for underserved age groups including young children, pregnant women and elderly people. The initiative launched in 2013 and runs clinics and hospital services in several states and communities where they’ve provided treatment to hundreds — in some areas, thousands — of patients.

The Bashir Fistula Foundation provides healthcare and connections to necessary medical resources to women suffering from obstetric fistula. Most all surgeries to cure the condition are fully paid for through partnerships between the Foundation and other organizations and medical centers. So far the Foundation has funded more than 100 surgeries.

The HER-Radio program improves the availability of radiotherapy and treatment for HER2+ breast cancer by offering a deferred payment plan for the 18-cycle treatment with the drug Herceptin. The interest-free, phased payment plan makes it possible for more people to afford treatment. Per the organization’s 2021 report, patients enrolled in the program save 15% to 25% on treatment costs.

The Okapi Cancer Foundation works to raise funds to support children diagnosed with cancer. On top of providing financial support for treatments, the organization also does advocacy work and childhood cancer awareness campaigns and also hosts yearly training for doctors providing cancer treatment to children. So far the organization has supported over 200 patients.

California’s Whole Person Care pilot program improved care for the state’s most at-risk Medicaid patients, like those experiencing homelessness and addiction. The program resulted in fewer hospitalizations and emergency room visits and also provided assistance in education, transportation, employment and helping participants access and maintain housing. The pilot program exists in 26 counties and served about 250,000 people.