Haebler, and Montera, (2016), describe one of the key roles of the Community Paramedic (CP) as gap filling. This description is an apt identifier for how the role of the CP makes a positive impact in their community. A CP is a local Emergency Medical Services Provider (EMS) who has refocused their mission from providing emergent care to instead focusing on needs in the community that used to be addressed by services such as public health, or home health. Often, the CP fills in where these services have either left off due to budget cuts, patient inability to qualify for services secondary to failure to access primary care, or patient has not even been identified as a candidate for services. The CP plays a role in helping to connect these
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Primary drivers for this situation are state regulations, and reimbursement methodology established by Medicare that only reimburses for transport to an ED. The end result of these policies is higher and higher demand, along with escalating healthcare costs. Estimates show that up to 15% of patients seen in the ED, transported by EMS, could be seen in a lower acuity setting. The reason for this is that people are seeking treatment for ongoing medical issues that could be addressed in other healthcare settings, and are in fact not urgent. If seen in non-urgent settings the result would be significant costs savings in the healthcare …show more content…
The only reimbursement is for transport to a hospital. This makes EMS reliant on a fee for service model of reimbursement. Further, the model for providing a transportation service does little to meet patient need. Patient’s who have a need for transportation to a primary care physician in order to have prescriptions renewed, or chronic disease management cannot have this need met by a 911 call and transport to an ED. CP seems to be a viable model to help redirect patients. Further, there may be times when an ambulance may be necessary to take a patient from home to the primary care office. However, with current fee for service models of reimbursement this is not possible. CP programs appear to be the beginning of a good thing, but evidence needs to be developed in order to support long term
Primary drivers for this situation are state regulations, and reimbursement methodology established by Medicare that only reimburses for transport to an ED. The end result of these policies is higher and higher demand, along with escalating healthcare costs. Estimates show that up to 15% of patients seen in the ED, transported by EMS, could be seen in a lower acuity setting. The reason for this is that people are seeking treatment for ongoing medical issues that could be addressed in other healthcare settings, and are in fact not urgent. If seen in non-urgent settings the result would be significant costs savings in the healthcare …show more content…
The only reimbursement is for transport to a hospital. This makes EMS reliant on a fee for service model of reimbursement. Further, the model for providing a transportation service does little to meet patient need. Patient’s who have a need for transportation to a primary care physician in order to have prescriptions renewed, or chronic disease management cannot have this need met by a 911 call and transport to an ED. CP seems to be a viable model to help redirect patients. Further, there may be times when an ambulance may be necessary to take a patient from home to the primary care office. However, with current fee for service models of reimbursement this is not possible. CP programs appear to be the beginning of a good thing, but evidence needs to be developed in order to support long term