Medics once trained and qualified to treat wounded service members will start making house calls to ailing patients in Northwest Arkansas if a pilot program takes off.
Ryan Cork is a U.S. Navy veteran and director of health care transformation at the Northwest Arkansas Council. He, area veteran Matt Hesse and Ronnie Crupper, a Bella Vista Fire Department battalion chief who is a paramedic, are working to start a community paramedics program in Northwest Arkansas, Cork said.
"Ryan and I were working together on a mental health task force and then with covid issues, talking about the needs we have in health care," said Crupper in a phone interview. "We talked with Matt Hesse and identified a lot of potential and outside expertise that we could use."
About 50 U.S. cities have such a visiting paramedic program, Cork said. Cork and his allies hope to recruit trained medics, with an emphasis on recruiting those leaving the armed services. The plan is to find jobs for these medics as emergency medical technicians in this region, said Cork and Crupper. Those needing further training could attend Northwest Arkansas Community College.
"These veterans lose their medical certification if they don't keep up their continuing education," Crupper said. Offering a job and a career path along with the training needed to keep their certification would make a lot of sense to them, he said.
The plan is not to compete with urgent care clinics or emergency rooms, but to ease the demand on them and to help patients who have trouble traveling to get health care, Cork and Crupper said in interviews. The program would serve Washington and Benton counties.
The trained paramedics would go to the homes of those needing medical assistance when a clinic is unavailable and the condition is not severe enough to warrant going to an emergency room, according to Cork.
The goal of the proposal is to save a single parent of three children from having to take all three on a trip to a local emergency room when one of them falls seriously sick and the family cannot get immediately in touch with a doctor, Cork gave as an example.
"We support efforts to help avoid unnecessary ER visits," said Jason Wilson, chief executive of Medical Associates of Northwest Arkansas, in a statement Thursday. "We encourage patients to have a primary care physician and to see their primary care physician or go to an urgent care clinic for non-emergency care." MANA is a physician-owned and led health group in Northwest Arkansas with 130 physicians and other health care providers.
One of the 50 regions in the United States with such a program is the Fort Worth, Texas, region. MedStar Mobile Healthcare is a government cooperating agreement between Fort Worth and 14 other member cities in north-central Texas, serving a population of 1.1 million.
"We had a handful of people who called 911 every day" in 2009, said Matt Zavadsky, spokesman for the organization. "To be frank, most of them did not have a payer source," being either uninsured or not qualified for other health care coverage. Some lived in rural areas where an ambulance responding could have taken that vehicle out of service for the rest of the system for up to three hours, he said Friday.
"We decided there's got to be a better way," Zavadsky said. Visiting paramedics not only ended a lot of unnecessary ambulance trips, but got to know the people involved in these cases.
"They could call and say 'OK, Larry, have you checked your blood sugar today?'" he said. "They prevented problems before they got started."
The visiting paramedics did not skim revenue off hospital emergency rooms because many of the people they were calling lacked the resources to pay all the expense of an emergency room visit and the required ambulance trip, Zavadsky said.
"Even if they had insurance, every insurance contract has language in it about a trip being 'medically necessary,'" he said. "Well, if the insurance says the ambulance and the emergency room treatment was not medically necessary and you try to get a $2,500 bill from someone who lacked the means to go to a clinic, good luck."
The key to a successful program like this is convincing insurance companies to reimburse the cost, and the figures are convincing, Zavadsky said.
"We started with a pilot program, and it made their chief financial officers and accountants happy," he said. "They set the metrics of what a pilot program would have to show. We spent the money out of our pocket for the pilot program and it met the metrics. Even Medicare is beginning to pay for this service in some of our communities because it saves them money.
"There's very little downside," Zavadsky said.
Cork hopes to have a detailed proposal and a contract with a vendor to manage a pilot program in six months, he said. Veterans joining such a program could avail themselves of recently expanded federal benefits to help pay for their education, he said. They would not be under any obligation to join a community paramedic program either, he said. They would have plenty of opportunity to work in other medical fields.
"We have plenty of jobs available for health professionals here," Cork said. Veteran health care professionals moving here would benefit the region whether they joined a community paramedic program or not, he said.
"I'm not selling a job. I'm selling a community," Cork said of recruiting veterans. Northwest Arkansas is nationally ranked as a desirable place to live by national real estate groups and magazines. Adding a solid career path would be an added attraction to the veterans, he said.
Hesse and Hesse's University of Health and Performance, a wellness-based educational institution, is in touch with veterans around the country and can find those leaving the service who would be interested in relocating to Northwest Arkansas, Cork said.
People leaving their enlistments in the military are usually "relatively young and fit," Cork said. Most who receive medical training in the military go on to work in a different field, and that is a waste of their training and talent, Cork said.
The right incentives would be convincing to a service member reentering civilian life, Cork said.
"We know it works," he said, citing the success of the "$10,000 and a bike" offer of the "Life Works Here" initiative. The council, with support from the Walton Family Foundation, offered $10,000 and a free mountain bike to 100 technology professionals and entrepreneurs to relocate to the region.
The project would also seek veterans who did stay in the health care field but are looking to relocate.
One of the region's attractions is the local job market, one in which a spouse of a health care worker moving here can also find a job in whatever field they work in, Cork said.
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Northwest Arkansas Council Health Care webpage:
https://nwacouncil.org/health-care/
MedStar Mobile Health programs in Fort Worth, Texas:
https://www.medstar911.org/mobile-healthcare-programs/