Complexity and Economic Value of Care Provided in Humanitarian Relief Clinics for Displaced Persons at the Mexico-US Border, 2020-2022.

OBJECTIVES: Millions of people rely on humanitarian organizations for medical care. We characterized the complexity and economic value of care provided by a humanitarian relief organization for displaced persons at the Mexico-US border. METHODS: We conducted a cross-sectional study of clinical encounters by a humanitarian relief organization in Tamaulipas, México, near US ports of entry from 2020 to 2022. We used records from a sample of medical encounters to assign ICD-10 and Current Procedural Terminology (CPT) billing codes for each encounter, procedure, or service. We derived an estimate of economic value for these encounters in 2020 US dollars by mapping the CPT billing codes to Medicaid reimbursement rates in Texas, and we compared these with a locally derived estimate using a fee schedule from the Instituto Mexicano del Seguro Social. We stratified economic value estimates by demographics, site of care, and type of medical service. RESULTS: From 23 339 clinical encounters representing 13 963 unique patients (59.5% female; median age 30 years), the most common codes were office visits: CPT 99202 ("office visit with a history") comprised 43.9% of all encounters. The most common procedure was obstetric ultrasound, present in 341 (1.5%) of all clinical encounters. The value of care was $39.18 per encounter, which was within 5% of the locally derived estimate. Evaluation and management services accounted for 95.4% of the value. CONCLUSION: This approach of assigning diagnosis and billing codes to clinical encounters provides an estimate for the value and complexity of clinical services provided by humanitarian relief organizations at the México-US border.