The Business Case for Community Paramedicine: Lessons from Commonwealth Care Alliance’s Pilot Program

Brief
Key Questions Answered
  • What is mobile integrated health care and community paramedicine (MIH-CP) and what are its benefits?
  • What is the business case for MIH-CP?
  • What is an example of an existing MIH-CP program, and what lessons does it hold for other programs?
Key Themes and Takeaways

This resource describes an analysis of a Massachusetts-based MIH-CP program called Acute Community Care (ACC), a pilot program of the Commonwealth Care Alliance. It assesses the business case for expansion to other geographic areas.

 

  • MIH-CP programs expand the role of emergency medical services personnel. In such programs, paramedics provide outpatient urgent and primary care–like services for patients who might otherwise visit an emergency department (ED).
  • Under the pilot program, patients diverted from the ED had lower average costs than those not diverted on a patient-episode basis (per patient savings were $791 for a seven-day period, $3,677 for a 15-day period, and $538 for a 30-day period).
  • To assess MIH-CP programs, an appropriate time frame is crucial; achieving net savings in less than 12 months may be unrealistic.
  • Modifications of various attributes could yield different financial outcomes for other programs. For example, a 10 percent increase in patient volume would increase savings by 18 percent, and a 2.5 percent increase in the average ED diversion rate would increase savings by five percent.
  • Estimating savings depends on reimbursement structure. Commonwealth Care Alliance is an integrated delivery system and able to retain all ACC program savings. MIH-CP programs that depend on reimbursement from other stakeholders may have a more complex equation.
Authors
Katharine W. V. Bradley
Dominick Esposito
Iyah K. Romm
John Loughnane
Toyin Ajayi
Rachel Davis
Teagan Kuruna
Population Addressed
Adults Under 65 with Disabilities
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Level of Evidence
Expert Opinion
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Key Questions

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