The Acute Community Care Program uses paramedics to provide in-home urgent care after regular business hours, aiming to prevent unnecessary emergency department visits.
Lisa I. Iezzoni, MD, MSc; Amy J. Wint, MSc; W. Scott Cluett III, NRP; Toyin Ajayi, MD, MPhil; Matthew Goudreau, BS, NRP; Bonnie B. Blanchfield, CPA, SM, ScD; Joseph Palmisano, MA, MPH; and Yorghos Tripodis, PhD
Am J Manag Care. 2018;24(9)
https://www.ajmc.com/journals/issue/2018/2018-vol24-n9/early-experiences-with-the-acute-community-care-program-in-eastern-massachusetts
PDF of the full report available here.
ABSTRACT
Objectives: Emergency departments (EDs) frequently provide care for non-emergent health conditions outside of usual physician office hours. A nonprofit, fully integrated health insurer/care delivery system that enrolls socioeconomically disadvantaged adults with complex health needs partnered with an ambulance service provider to offer after-hours urgent care by specially trained and equipped paramedics in patients’ residences. The Massachusetts Department of Public Health gave this initiative, the Acute Community Care Program (ACCP), a Special Project Waiver. We report results from its first 2 years of operation.
Conclusions: This study using observational data provides preliminary evidence suggesting that ACCP might offer an alternative to EDs for after-hours urgent care. More rigorous evaluation is required to assess ACCP’s effectiveness.
Takeaway Points
The Acute Community Care Program (ACCP) is a collaboration between a nonprofit, fully integrated health insurer/care delivery system that enrolls socioeconomically disadvantaged adults and an ambulance service provider to offer after-hours urgent care by specially trained and equipped paramedics in patients’ residences. Without ACCP, these patients would typically be sent to emergency departments (EDs).
Early results suggest that:
- ACCP appears to reduce ED visits for these urgent care patients.
- No unexpected deaths occurred.
- At least 90% of patients are willing to receive ACCP care in the future.
- More research is needed to quantify the effects of ACCP on ED use and patients’ experiences.
