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

Issue Brief
Publisher: Hamilton, NJ: Center for Health Care Strategies, Inc.
Dec 06, 2016
Katharine W. V. Bradley, Dominick Esposito, Iyah K. Romm, John Loughnane, Toyin Ajayi, Rachel Davis, and Teagan Kuruna

Key Findings:

  • Community paramedicine patients who were successfully diverted from emergency room care had lower average costs than those not diverted.
  • Patient volume is a strong driver of community paramedicine savings estimates.
  • The emergency room diversion rate is also a primary driver of savings estimates.
  • Savings estimates are sensitive to operating cost increases; managing aggregate costs of personnel, clinical supervisors, and program administration will be important to support sustainability. 
Mobile integrated health care and community paramedicine (MIH-CP) programs expand the role of traditional emergency medical services personnel to address non-emergency needs and bring outpatient primary and urgent care into patients’ homes. These programs offer potential for reducing health care costs, eliminating unnecessary emergency department use, and shifting service back to community-based and home settings. Between 2014 and 2015, the Massachusetts-based Commonwealth Care Alliance (CCA) piloted a community paramedicine program, Acute Community Care (ACC), to serve its members in the Greater Boston area. This brief summarizes ACC’s business case assessment, which showed that increasing patient volume after the pilot period would result in net savings given the program’s success in averting unnecessary emergency care. By illustrating cost considerations for an expansion of MIH-CP services, this brief may inform the design and sustainability planning of other MIH-CP programs.