Funder: Kaiser Permanente Community Benefit

Author: Katharine W. V. Bradley and Dominick Esposito, Mathematica Policy Research; Iyah K. Romm, John Loughnane, and Toyin Ajayi, Commonwealth Care Alliance; and Rachel Davis and Teagan Kuruna, Center for Health Care Strategies

December 2016 | Brief


As complex care programs across the country turn toward innovative workforce developments, mobile integrated health care and community paramedicine (MIH-CP) programs are increasingly being implemented and tested. These programs expand the role of emergency services personnel to provide outpatient and primary care-like services in patients’ homes, particularly for individuals who might otherwise visit or be transported to an emergency department (ED). However, because these potentially promising programs are still in their early stages, interest in the cost-saving potential of MIH-CP programs has outpaced the availability of evidence of return-on-investment to date.

To test the value of community paramedicine for its members, the Massachusetts-based Commonwealth Care Alliance piloted the Acute Community Care (ACC) program, an ED-diversion initiative, between 2014 and 2015. With support from the Center for Health Care Strategies and through the Kaiser Permanente Community Benefit-funded Complex Care Innovation Lab, Commonwealth Care Alliance worked with Mathematica Policy Research to assess the business case for ACC. This brief summarizes the business case assessment and illustrates considerations for designing and planning other MIH-CP programs. The accompanying business case tool provides an interactive way to explore how changing cost drivers impact savings projections.