Community Paramedics Address Health Inequities Within EMS Through Mobile Integrated Healthcare (MIH) Program Referrals from a "Medical Home".

To advance local health equity, a large urban fire department's Mobile Integrated Healthcare (MIH) Unit worked with a Chicago-based health care organization to refer patients in "medical homes" to a MIH program. Medical home coordinators referred individuals to Community Paramedics (CPs) in the MIH Unit for program enrollment with a 4-visit model in 4 clinical pathways (hypertension, diabetes, asthma/Chronic Obstructive Pulmonary Disease [COPD], and heart failure). A total of 911 utilization of ambulance transportation, emergency department (ED) visits, and inpatient hospitalizations before and after intervention were measured to gauge program impact. A postgraduation survey was distributed to participants. From November 2022 to March 2025, 68 referred individuals completed the program and graduated with a total of 321 in-person visits by CPs. Data were gathered for 6 months before program enrollment and 6 months post-intervention. The most common clinical pathway for graduated patients was hypertension (75%), diabetes (57%), asthma/COPD (47%), and heart failure (41%). Among graduated patients, there was a 43% decrease in 911 ambulance transports, a 46% decrease in ED utilization, and a 42% decrease in hospital admissions. The postgraduation survey was completed by 53% of program graduates; 81% reported symptom improvement, 58% indicated an improved relationship with their primary care clinic, and 74% agreed that CPs improved their overall health care experience. Creating a partnership between a patient's primary care medical home and a large urban fire department's MIH program is a successful strategy for decreasing 911 ambulance transports, ED utilization, and inpatient hospital admissions for individuals at risk for poor health outcomes.