A common sense approach to home health care
Rep. Tina L. Spears and Sen. Victoria Gu are
introducing legislation to establish sustainable funding and reimbursement
rates for ambulance services to practice community paramedicine and “treatment
in place” programs.
Tina and Victoria are a great team who deliver for Charlestown
Community paramedicine, or mobile integrated health (MIH),
allows emergency medical services agencies to proactively provide preventative
care in a patient’s home, help manage chronic conditions, conduct follow-up
visits and connect residents with the appropriate local health and social
services.
“Treatment in place” refers to when EMS providers treat a
patient outside of a hospital for a more minor medical incident that does not
require transportation to a hospital for care.
Both approaches reduce health care costs and strain on hospital and EMS
resources, but are not currently covered or reimbursed by insurance in
Rhode Island.
“Emergency medical service personnel are already providing important community medicine in Rhode Island, preventing emergency room visits and extended hospital stays in the process. Unfortunately, our reimbursement system still follows the outdated payment model that assumes that ambulance services only provide health care services during visits when they transport a patient to the hospital,” said Representative Spears (D-Dist. 36, Charlestown, New Shoreham, South Kingstown, Westerly).
“By reimbursing ambulance services
for the actual care they provide when treating patients in place and extending
insurance coverage for community paramedicine, we can improve the quality of
care patients receive across Rhode Island, especially in rural areas.”
Said Senator Gu (D-Dist. 38, Westerly, Charlestown, South
Kingstown), “Community paramedicine is increasingly used in rural communities
to bridge critical health care gaps caused by geographic isolation, limited
provider availability and transportation barriers. By treating patients where
they are and addressing concerns early, we can reduce emergency room visits,
lower health care costs, and improve overall outcomes. Strengthening this model
supports our EMS providers while keeping residents healthier and safer at
home.”
The bill (2026-H 7485, 2026-S 2685) would ensure that health insurance plans
reimburse ambulance services at the Medicare rate for the care they provide,
whether or not the patient is transported.
A similar version of this bill was introduced last year by
House Judiciary Chairwoman Carol Hagan McEntee, who is a cosponsor of this
year’s bill in the House. Representative Spears and Senator Gu credit
Chairwoman McEntee with bringing this issue to statewide attention.
EDITOR'S NOTE: Cathy and I are really grateful to Charlestown Ambulance and Rescue for all their help. I think it would be wonderful if they were able to provide expanded services with full and fair coverage by Medicare and insurers. It seems to be cost-effective and common sense that they should be able to do more than just transport patients to the hospital. - Will Collette
“EMS providers do lifesaving work on the frontlines of medical emergencies across Rhode Island, and it is only fair that we reimburse them for this work, whether or not it involves transporting patients to a hospital,” said Chairwoman McEntee (D-Dist. 33, South Kingstown, Narragansett).
“When EMS providers treat a patient in place, it reduces the strain on our
emergency rooms, lowers overall health care costs and improves the quality of
care for patients, especially those in rural parts of the state. It is important
that we fund this important community health care and it is vital that we do it
soon, for the sake of our communities and the health of our statewide health
care system. I wholeheartedly support this bill and look forward to testifying
when it reaches committee.”
The bill would also task the Rhode Island Department of
Health, in coordination with the Ambulance Service Coordinating Advisory Board,
to set up the rules and regulations necessary for MIH programs in the state.
EMS agencies would need to submit plans and stay in compliance to participate.
MIH programs are already in place in some communities in
Rhode Island, usually supported by grant funding. This bill would provide a
sustainable funding model to allow existing programs to expand their services
and new programs to launch in communities where they are needed.
“Treatment in place and MIH are smart public policy and good
medicine. This legislation recognizes that EMS delivers health care, not just
transportation, and ensures reimbursement reflects the level of care actually
provided. By supporting treatment in place and community paramedicine programs,
Rhode Island is strengthening patient-centered care, reducing unnecessary
emergency department visits, and improving outcomes for the communities we
serve,” said Chief Andrew Kettle of the Charlestown Ambulance-Rescue Service.
