The Kaiser Family Foundation defines the social determinants of health as “the conditions in which people are born, grow, live, work, and age. They include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care.”

Because the state of Nevada overall and member hospitals themselves face significant population health challenges directly attributable to the social determinants of health, NRHP decided to focus on implementing a population health initiative. With federal funding from the Health Resources & Services Administration (award no. D06RH31058), a subset of four Critical Access Hospitals in the NRHP membership have come together to deliver community paramedicine services to rural patients. This service is underpinned by HealthCall, a care management platform that uses mobile health device integration to give doctors access to near real-time patient data. By taking a network approach to create and adopt this new process of population health management, each network member can adopt community-specific best practices to treat their chronic patient population.

In May of 2015, Nevada Assembly Bill (AB) 305 was signed into law legalizing “community paramedicine” and Nevada Medicaid began reimbursing for community paramedicine home visits. Community paramedicine as delivered in the home includes patient evaluation/health assessments; chronic disease prevention, monitoring, and education; medication compliance; immunizations and vaccinations; laboratory specimen collection and point of care lab tests; hospital discharge follow-up care; and home safety assessments.

Through the utilization of remote biometric health monitoring devices from Zewa, this program has provided primary care providers with the technology to track their patients’ health outcomes in real-time without ever requiring a face-to-face follow-up visit. For a patient to receive these services, a primary care provider writes a patient’s care plan to include community paramedicine, a community paramedic meets with the patient (sometimes during their primary care visit) and the patient can begin to receive the needed services at a convenient time in the comfort of their own home.

For more information on community paramedicine in NV, please visit: https://dhcfp.nv.gov/Pgms/CPT/CP/CP/ and https://www.ruralhealthinfo.org/toolkits/community-paramedicine/3/nevada