As the EMS provider for more than 880,000 people in the greater Fort Worth area, MedStar sees abuse of 9-1-1 system multiple times a day. In 2008, 21 individual patients were transported to area emergency rooms more than 800 times by MedStar, resulting in $962,429 in ambulance charges (not including the charges from the hospital emergency departments). Majority of these bills are uncollectible. A large number of our population is using EMS as a health care safety net.
This is a scenario played out all across the country. While the national debate on health care reform continues, we at MedStar felt it important to address the problem immediately, and locally.
In July 2009, MedStar implemented the Community Health Program that identified high system users and developed individual care plans for each of those patients.
As part of that care plan, the enrolled patient receives regularly scheduled home visits by one of our Advanced Practice Paramedics. During those home visits the paramedic provides a medical assessment, ensures the patient is taking their prescribed medications and is following up with an assigned primary care provider. They also provide some often much-needed social interaction for these patients.
The program classifies enrolled patients into three categories:
| Active |
Daily visits sceheduled by the Advanced Practice Paramedic |
| Graduated |
Enrolled in the program, but receiving client-scheduled visits only, as needed |
| Pending |
Client referred and awaiting care plan approval |
| System Abuser |
Determined a system abuser by the Emergency Physicians Advisory Board. Patients only transported to designated medical facility, regardless of patient request |
The goal of the Community Health Program is to reduce the unneeded 9-1-1 calls and EMS transports that put strain on an already overloaded emergency system, provide the patient more appropriate health care (as opposed to the emergency room), as well as reducing overall healthcare costs.
Since its' inception, it is estimated that the program has saved more than $1.3 million in emergency room charges, and reduced 9-1-1 use by these patients by nearly 50 percent, saving nesrly $1 million in EMS charges. Click on the links below to see how to refer clients and to see the current use and economic analysis of the clients enrolled in MedStar's Community Health Program.