Mesa firefighters who respond to low-level 911 calls are now taking along medical staff from a hospital under an experiment to lower the cost of emergency treatment while improving patient service.
The arrangement is expected to free up firefighters and equipment for true emergencies, instead of bogging down crews on calls for broken ankles or sore throats.
The Mesa-based Mountain Vista Medical Center will supply a nurse practitioner for some calls now staffed entirely by the fire department. The team will arrive on calls in a new fire department response vehicle that has a private area to treat patients and many of the same items found in a doctor’s office.
And unlike a city-employed paramedic, the hospital’s nurse practitioner can write a prescription on the spot.
Mesa Fire Chief Harry Beck said the new approach should speed up patient treatment and keep people out of emergency rooms.
“That’s a huge improvement in patient care,” Beck said.
The hospital’s involvement builds on another successful experiment to use fire department staffing more nimbly. The city in 2006 broke with a tradition of sending a nearly million-dollar fire truck and crew of at least four firefighters to every medical call because those crews are more equipped for fires, hazardous materials calls or life-threatening medical emergencies.
Instead, Mesa fire dispatchers triage 911 calls and assign low-level responses to two-person Transitional Response Vehicles, which are staffed with just two paramedics. The TRV response cost is about half that of a traditional crew. Mesa has four TRVs today.
The agreement with Mountain Vista will replace one TRV crew member with a hospital employee. Just one unit will operate that way for now as the city and hospital evaluate its performance.
Mesa talked with several hospitals that declined to test the new response attempt. Mountain Vista was interested because of the potential to reduce low-level emergency room visits and free up the staff for critical patients, hospital CEO Tony Marinello said.
The nurse practitioner will follow up with the patient afterward to make sure medication is being taken and that the person’s condition is improving. That is expected to reduce costs by making hospital readmissions less common.
Mesa Mayor Scott Smith said the experiment offers potential to reduce the cost of uninsured people calling 911 or going to an emergency room for basic treatment because those are the only options they’re aware of.
“So people get health care, but they get health care in the most expensive and inefficient way possible,” Smith said. “We’re trying to bridge that gap.”
Vice Mayor Scott Somers, who is also a Phoenix firefighter, approached Mountain Vista with the idea. The approach could shift some expenses that Mesa pays as the hospital can bill insurance or Medicare for some services, he said. Mountain Vista has the potential to use its staff more efficiently but he said the hospital likely won’t make money.
“For this first trial run, it’s going to be a loss until we figure out where all the moving parts are, so it takes an act of courage from the private partner to engage in this project,” Somers said.
A few cities have tried parts of Mesa’s plan, Somers said. Phoenix Fire ended a similar program years ago as hospitals resisted it, he said. But hospitals will likely be more open now because of escalating costs and new insurance billing rules. Mesa officials said they would reach out to other hospitals if the pilot is successful.
Somers said the program could be a new model for cities and hospitals to drive down costs.
“I really think that we’re onto something here and I’m really interested in seeing the economics of this,” Somers said.
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