N.C. County to Launch Paramedicine Program

BY: McClatchy / EMSWORLD

May 9—Haywood County and Haywood Regional Medical Center will be teaming up to form a paramedicine program.

Programs such as these allow paramedics to perform an advanced role in community medicine by helping those identified as high risk connect with other services such as Meals on Wheels, energy assistance or getting prescriptions filled. Those identified as ideal candidates for the service are individuals who are at risk for hospital readmission or who tend to use a county’s emergency services for primary medical care.

Rod Harkleroad, chief executive officer at the hospital pitched the idea to the county last year, offering to invest $200,000 in the program over the next two years to get it jump-started.

“From your end, the biggest expense is a vehicle,” Harkleroad said, noting the hospital will pay for the cost of a full-time paramedic, as well as provide $60,000 worth of cardiac monitoring equipment for the vehicle. “The worst case scenario if the program doesn’t work is you’ll have the vehicle and a monitoring system to use in other trucks.”

The hospital sees a paramedicine program as a way to cut down hospital readmissions, which are reimbursed at a lower rate by Medicare, Medicaid and insurance programs. County emergency officials are hoping the program can cut down on the number of calls from those who repeatedly call on county emergency medical services.

“At this time, our readmission rate is really good, but we have $24 million in bad debt,” Harkleroad said. “If we can reduce the number of frequent fliers, it will be a win for the county and the hospital.”

Mike Street, who heads the county’s emergency medical program, said many other counties have started paramedicine programs to cut down on calls and reduce trips to the hospital.

Through call records, those who frequently call upon EMS can be identified and targeted as in need of another layer of care.

“McDowell dropped EMS calls by 4.2 percent,” Street said, noting that from the EMS standpoint, a paramedicine program offers cost avoidance. “EMS is in a unique position. Folks know us. We’re in their house regularly.”

That makes a paramedic the ideal person to help an individual connect to programs that can help address their medical problems longer-term.

“This is not a new concept,” Street said. “It’s gone on throughout the country. All have same results — call reductions, as well as reductions in readmissions to the hospital and visits to ER. We haven’t been able to find a negative.”

Greg Shuping, the county’s emergency service director, noted the proposed county budget presented to the commissioners earlier in the meeting did not include the $36,000 the county would need to provide for the vehicle needed by the program.

“This is good for quality of life in the community and for the health and finances of the hospital,” said Commission Chairman Kirk Krikpatrick, who asked for a motion to approve concept of a community paramedicine program and authorize a contract to be reviewed and entered into with the hospital, along with a budget change to fund the program.

The motion passed unanimously.

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