Item 4 - Report on Mobile Healthcare Services Option

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1Health Care Reform Initiative Health care in the United States is undergoing a series of sea-changes with the recent passage of the health care reform bill. In this dynamic environment, we are proposing federal assistance in reshaping the access to our health care system as a means to initiate improvements. The goals for this project are: Improve access to prehospital primary health care for all people Improve patient health outcomes Lower the overall system cost of health care This will be accomplished by applying proven models of prehospital health care delivery in new and unique ways that result in a more effective match between the severity of illness or injury and the level and timeliness of care delivered. The vision for this project is to more effectively link public safety and community health in a public-private partnership by redesigning the elements of the existing system into an integrated Mobile Healthcare Services (MHS) system. 2Definition of the Issue In the last year, our country has embarked on a journey of health care reform, toward providing all people with access to appropriate health care. This journey of reform also includes improving the delivery mechanism for health care, ensuring that the right care is delivered in the most cost effective manner. Presently, the type of care actually needed and the care provided is often mismatched. Too often, injured or ill people don't have access to the right level of care at the right time. Far too often, the current Emergency Medical Services (EMS) system is inappropriately used to provide non-emergency health care. In other cases, people fail to recognize the seriousness of the illness or injury and hesitate to call for emergency help when they really need it. This results in either over- access or under-access decisions by patients or those near them at the time. Over-access leads to unnecessary levels of care and expense, overtaxing the limited resources of the 9-1-1 EMS system and Emergency Departments (ED) and a significant increase in uncompensated services. Under-access and resultant delays in care result in more serious patient health outcomes and some may ultimately lead to unnecessary death. All this is occuring at a time when the national economy is challenged and reimbursement for medical care is being systematically reduced. A study by ED physicians reported 30 % of all ambulance transports to EDs were not medically 1 necessary. 2