Host Integrated - the Community Paramedicine podcast Boston, Pennsylvania
Jonah Thompson, BA, NRP, CP-C: No financial relationships to disclose
Partnering with commercial and government health insurers represent critical relationships and future revenue models to sustain Mobile Integrated Health programs. As these programs move beyond direct referrals made by clinicians, identifying who is appropriate and can be positively impacted by MIH based on member demographics and claims history is a process outside most traditional prehospital care operations. MIH leaders must work with business intelligence and claims analysts to define criteria that translate actuarial risk to the payer into clinical and social care opportunities that Community Paramedics and MIH programs are well suited to address. This presentation will share lessons learned from multiple funded pilot projects between a large health system MIH program and several commercial or government payer organizations.
Upon completion, participants will distinguish between clinical referral processes and informatics driven selection
Upon completion, participants will distinguish payer incentives and priorities from clinical goals
Upon completion, participants will describe filter and selection variables effective at identifying appropriate patient referrals from member databases