Quality Insights Awarded Special Project to Test Paramedic-Delivered Expanded Care Services in West Virginia Communities


Quality Insights has received funding from the Centers for Medicare & Medicaid Services (CMS) to help emergency medical service (EMS) providers offer expanded care to people with Medicare who live in West Virginia. The goal of this collaboration is to lessen unnecessary hospital admissions and emergency department visits while enhancing access to quality care for the state’s most vulnerable and rural residents.  
Hospital readmissions and emergency department visits are common and costly, particularly for people with chronic conditions and the elderly. In an effort to address this issue, Quality Insights will support EMS providers that offer mobile integrated health care services – commonly called “community paramedicine” – to help patients and hospitals with high rates of emergency department use or a large number of patients who are frequently readmitted.
Specifically, Quality Insights will help:
  • Identify causes of hospital readmission or emergency department use
  • Develop and conduct assessments to identify local needs
  • Provide reports to participating health care providers that identify key drivers of hospital readmission
  • Select and share best practices to address key drivers of hospital readmission and emergency department overuse
  • Develop resources and educational materials to support both patients and health care providers
  • Engage patients and their families as partners through feedback on proposed strategies, usefulness of educational materials and assessment of improved knowledge as a result of community paramedicine efforts
Community paramedicine is an emerging health care delivery model that increases access to basic services through the use of specially-trained EMS providers in an expanded role. Community paramedics provide care at home under the supervision of a physician or an advanced practice nurse.  They can help fill gaps in rural health delivery caused by a shortage in available providers as well as long travel times to hospitals or clinics. Community paramedics are also considered trusted health care professionals and are often members of the community where they serve.
“This project aims to provide appropriate care to the right patient, at the right time and in the right setting,” Beckey Cochran, Quality Insights’ Quality Innovation Network Director said. “Patients will remain at home for non-emergency medical needs that do not require hospital or emergency department services. This will hopefully result in a reduction in unnecessary hospital readmissions and as emergency department visits, and more importantly improve patient safety and access to care.”
Quality Insights will work with consultant James Mason to implement the project. Mason has experience as a paramedic in four states. He became involved with community paramedicine in 2014, while a Rural Health Initiative student at the West Virginia Osteopathic School of Medicine. He helped achieve passage of a Senate bill for community paramedicine demonstration projects. He coordinated community paramedicine development with 19 agencies and 44 health care entities in West Virginia. 
“Mr. Mason’s experience and knowledge around community paramedicine will be critical to bridge the gap between existing care coordination efforts and new opportunities,” Cochran said.
“This program is important because we’re going to be able to bring quality health care to the most rural and vulnerable citizens in West Virginia,” Mason said. “Paramedics are often viewed as ‘transportation-only’ providers. We’re hoping to expand that viewpoint into the health care provider realm.” 
“This program is important because we’re going to be able to bring quality health care to the most rural and vulnerable citizens in West Virginia,” Mason said. “We hope to expand the viewpoint of the type of services that paramedics provide into more of a comprehensive health care provider realm.” 
A community paramedic can address both medical and social needs. Community paramedics can provide home safety assessments, triage and referral services, chronic disease management education, support for family caregivers, medication compliance support, vaccinations and more.
“Offering community paramedicine services will allow patients to choose to use community resources rather than inpatient and emergency facilities for non-urgent care,” Cochran said. “This will also empower hospital-based doctors, who might be concerned about the availability of resources for chronically-ill patients, to make referrals for high-utilizers to the program.”
For more information about this project, contact Biddy Smith at bsmith@qualityinsights.org, or call (304) 346-9864 ext. 3252.