Community paramedicine (CP) is a locally designed, community-based, collaborative model of care that leverages the skills of paramedics and emergency medical services (EMS) systems to take advantage of collaborations between EMS and other health care and social service providers. Community paramedics receive specialized training in addition to general paramedicine training and work within a designated program under local medical control as part of a community-based team of health and social services providers.

A growing national movement toward better and expanded use of paramedics to address community needs is taking root in California. Pilot projects across the state are testing whether the emerging field of community paramedicine can play a role in improving population health, reducing costs, and improving the patient’s experience with health care.

This case study describes CP pilot projects in five California communities that provide patients who have been recently discharged from hospitals with timely follow-up visits, calls, or both. The main goal of the postdischarge pilot projects is to reduce the number of patients readmitted to the hospital within 30 days.

Key highlights:

• Reducing Hospital Readmissions. Hospital readmissions within 30 days of discharge decreased for all sites and diagnoses except at one pilot site. This site served only heart failure patients and provided less intensive services than the other postdischarge pilot sites.
• Patient Safety. An independent evaluation found that no adverse outcomes were found to be attributable to any of the pilot projects. Evaluators also found improvements in patient safety due to the work of community paramedics involving medication reconciliation, obtaining prescription refills in a timely manner, and securing follow-up appointments with clinicians.
• Cost Savings. Four of the five pilot sites saw significant cost savings for payers, primarily Medicare and Medi-Cal, due to reductions in inpatient readmissions. The fifth pilot site reduced 30-day readmissions but the reduction was too small to offset the cost of operating the project.

The full issue brief is available below.

Watch this video to learn more about community paramedicine.