What does the future hold for mobile integrated health care?

Experienced leaders of U.S.-based community paramedic programs answered questions about the current state and future of community paramedicine


JACKSONVILLE, Fla. – A panel of mobile integrated health care and community paramedic experts answered questions from EMS chiefs and executives at the Pinnacle EMS Leadership forum.

The questions answered by the panel included:

  1. Can we definitely say that MIH/CP programs are meeting the Institute for Healthcare Improvement’s Triple Aim?
  2. How can we uniformly measure the results of MIH/CP programs?
  3. What are common best practices for implementing a program?
  4. With CMS payment reform a long-term goal, how can agencies make MIH/CP sustainable in the short run?
  5. How are MIH and CP programs different, in terms of the concepts, between the EMS role in urban vs. rural settings?
  6. What is, or can be, the role of the fire service in MIH/CP?
  7. What are the barriers and challenges to making MIH/CP a continuing national trend?
  8. What do other health care stakeholders and payors think?
A panel of mobile integrated health care and community paramedic experts answered questions from EMS chiefs and executives at the Pinnacle EMS Leadership forum. (Image Greg Friese)
A panel of mobile integrated health care and community paramedic experts answered questions from EMS chiefs and executives at the Pinnacle EMS Leadership forum. (Image Greg Friese)

Memorable quotes from expert panelists:

"There is as much evidence – a moderate level – for the effectiveness of community paramedics as there is for other health care innovations." - Dan Swayze, vice president, Center for Emergency Medicine, University of Pittsburgh

"Find the local relationships to build a value proposition with local funders. When you can clearly articulate value you will find local funding." - Matt Zavadsky, director of public affairs, Med Star Mobile Health

"Delivery system reform and payment system reform: which comes first? The answer is both." - Brenda Staffan, Medicare Innovation grant project manager, Reno (Nev.) Regional EMS Authority

"Uniform measurement will be the key to reimbursement for community paramedic programs." - Gary Wingrove, director of strategic affairs, Mayo Clinic Medical Transport

"The unit of analysis linking all of these discussions is the populations we serve." - Eric Beck, associate chief medical officer for Evolution Health and American Medical Response

Key takeaways:

Several themes emerged as the panelists answered the questions.

  • Planning, including an aim and focus, are important to successfully launching a community paramedicine program.
  • Providing services across and beyond existing jurisdictional boundaries is important to success.
  • Super utilizers, people using a disproportionate amount of health care resources, is the top reason for starting a community paramedic program
  • Start with local, small and focused community paramedicine initiatives.
  • There is significant interest in community paramedicine from other health care organizations.
  • Health care reform is a significant challenge and a significant opportunity for EMS.

The session concluded with a review of survey responses from agencies that participated in an executive forum for community paramedic program leaders. The survey data, to be released in full soon, was responses to questions about reasons to have a community paramedic program, staffing, funding, and successes. 

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