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Accountable Care Organisations fund the gap—how to get community paramedic programmes paid

02 December 2015
Volume 5 · Issue 3

Abstract

Community care paramedic services In the United States (US) are seeking solutions in the wake of the Affordable Care Act. Health care is moving into a new era: it is transitioning away from a fee for service model to a model based on continued improved patient outcomes. This shift to focused patient-centered care is nothing new to paramedics. They sit in the community waiting to respond at a moment's notice to provide life-saving and life-sustaining care from the time they are dispatched, to the time they arrive at the emergency room. With the implementation of community care paramedic programmes they have the opportunity to expand upon simply providing transport services. Now the opportunity exists to not just sit and wait for the emergency but to be part of keeping patients from getting sicker and helping to manage them before they call 911. Finding a way to fund community paramedic programmes that provide these much needed healthcare services is where the current healthcare reform will provide solutions. Filling the gaps between integrated community health care services is viable through existing Accountable Care Organisations that are supported legislatively and can fiscally help these programmes succeed in this new era of health care.

On 23 March 2010 President Obama signed a new health care reform act into law. The Patient Protection and Affordable Care Act (ACA) will finally change the way health care is to be delivered in the US. This will provide community paramedic programmes expanded avenues of funding they desperately need. These vital community services will need to find a sustainable source of revenue to continue providing health care to their communities. It is with sustainable funding that the ACA provides solutions to meet these needs. Community paramedics can seek reimbursement within the ACA by developing patient care services that meet established improved patient outcome guidelines. Because of their unique position in the community they can easily integrate with other existing community services that are part of current accountable care organisations (ACOs).

This expanded role of an emergency medical system is a cornerstone of community paramedic programmes. Their ability to work with home health services, primary care physicians and emergency departments directly inside the community is a unique function not being currently used. Helping to fill the gap between scheduled home nurse visits, or discharge from an outpatient clinic or emergency department at a patient's home, is the primary function of community paramedic programmes. These services can all be part of an ACO where community care paramedics can provide a valuable service. They can help provide health care in patients' homes until they can be managed through patient-centered medical home coordinated care process. It may take days to get a home health nurse to a patient's home after discharge. Community paramedics can be there any time day or night.

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