Scaled-back ambulance service could avoid unnecessary ER visits

Some ambulance services now use smaller vehicles and diversify their resources to save money on healthcare delivery, Kaiser Health News reported.

South Metro Fire Rescue Authority in Denver deployed what the organization calls a "mobile care unit" rather than a full ambulance--a crossover SUV that essentially makes house calls rather than transporting patients to the hospital.

"We created a mobile care unit that can go to a given patient, if we think they're safe to treat on scene, and provide definitive on-scene treatment," Rick Lewis, chief of South Metro's emergency medical services, told KHN.

A nurse practitioner is on the unit so he or she can prescribe drugs if necessary. The unit also has a mobile laboratory to do blood counts or basic testing for infections such as strep throat. A computer is also on board so staff can access Colorado's nascent medical records network and call up specific patient data--KHN referred to it as urgent care on wheels.

"A lot of what we do is sort of that mid-level between the acute care you receive in an emergency department and what the paramedics can currently do," Eric Bleeker, advance practice paramedic, told the publication.

The mobile care unit is a compromise for patients who want care but not necesarily at the hospital, as well as ambulance companies wary of being sued if they don't provide any sort of service. South Metro can provide care at a patient's house for about $500. That's about one-sixth of what it would cost to render treatment at a hospital emergency room, KHN reported, and likely far less than the bill the patient would receive for an ambulance ride itself.

South Metro has yet to charge for mobile care service because insurers will not cover it, but officials with the service suggest it could be reimbursed later once it shows it can cut the overall costs of providing care. It may also take some heat off of ambulance providers, which have been criticized for overcharging Medicare in the Philadelphia area and other parts of the country. The Centers for Medicare & Medicaid Services suspended the acceptance of new ambulance provider applications earlier this year over concerns about fraudulent practices.

To learn more:
- read the KHN article

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