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Dickinson County hears early results of community paramedic MIH program and a plan to bill insurers for in‑home visits
Summary
County presenters described a community paramedic program that has completed about 200 patient encounters in six months and produced roughly 81 clinical interventions; the county is negotiating a vendor contract that would seek reimbursement (about $120/hour billed to Medicaid/Healthy Blue) to sustain the service without upfront county cost.
Commissioners heard a briefing on July 2 about Dickinson County’s Mobile Integrated Health (MIH) community paramedic program, including early outcomes and a vendor model intended to secure insurer payments to sustain and expand services.
John (presenter) and Alex, a community paramedic, described how the program operates: physicians and advanced providers refer patients for home visits focused on fall prevention, medication management and transitional care following hospital discharges. Alex said the team averages three to four encounters per day during weekday MIH shifts and reported about 200 patient encounters in the first six months with roughly 81 clinical interventions — nearly 40% of encounters — that included wound care, medication reconciliation and other measures that kept patients out of the emergency department.
Contract and billing model: Staff presented a contract structure with a vendor that would negotiate reimbursement from Medicaid and Healthy Blue for MIH services at about $120 per hour, billed in 15‑minute increments, with no upfront cost to the county. Under that arrangement the vendor would seek insurer payments and remit program revenue; staff said the model is already being used in other jurisdictions and that Johnson County has started its own MI program.
Program benefits and examples: Alex shared case examples where medication mismanagement and lack of home safety devices increased ER visits and nursing‑home risk; he described a case in which organizing medications and providing caregiver support helped a patient avoid institutional care and regain independence. He also noted frequent findings of missing or nonfunctioning smoke detectors and said the program connects residents to free fire‑department installs.
Commissioner response and next steps: Commissioners praised the program and urged staff to pursue stable funding. Several commissioners suggested leveraging state and federal interest — including outreach to the senator’s office and a Georgetown University research request noted in the presentation — to secure grant or legislative support. Staff said they will consider a formal recommendation on sustaining the program and potential county endorsements, and will continue to present MIH outcomes at upcoming state conferences.
What to watch: The county will track whether the vendor billing model secures consistent reimbursement from Medicaid and private insurers, and whether documented reductions in ER revisits translate into measurable cost savings for the county’s healthcare system.
