Community paramedicine sends medics into homes. Resident telehealth gives households a clinician line so many problems never become a response. One needs a truck crew; the other does not.
What is community paramedicine?
Community paramedicine (often grouped with mobile integrated health) uses EMS clinicians for scheduled or follow-up work outside 911 transport: post-discharge checks, frequent-caller visits, wound checks, and some treat-in-place care. NHTSA’s Office of EMS collects the national picture at EMS.gov.
CMS’s Emergency Triage, Treat, and Transport (ET3) Model, which ended December 31, 2023, paid ambulance suppliers for treatment in place and transport to clinics, not only emergency departments. See CMS ET3. A Medicare payment test, it neither created citywide resident telehealth nor funded extra medics.
When the hospital is far, a medic in the living room can be the only same-day option. HRSA tracks rural access at HRSA Rural Health. That argues for CP, and against spending medics on work a phone clinician can close.
What is resident telehealth?
A city-funded virtual line for residents: no 911 call, no home visit. A licensed clinician handles primary-care complaints and tells true emergencies to call 911. TAP Health runs this with 780+ public-sector partners.
It does not replace a home visit for a fall risk, a wound vac, or a patient who cannot describe symptoms. It takes fever, rash, UTI, refill, and “is this an emergency?” off the stack.
Cost, staffing, and scope
| Community paramedicine | Resident telehealth | |
|---|---|---|
| Who shows up? | A medic, in person | A clinician on the phone or video |
| Staffing | FTE or overtime on the EMS roster; medical-director time | Vendor clinicians; no new city medics |
| Scope | Home assessment, some treat-in-place, frequent-caller work | Low-acuity primary care for any resident who calls |
| Covers people who never call 911? | Only if you schedule them | Yes |
| Capital | Vehicle, kit, protocol, often union notice | Contract and public notice |
| Does not do | Scale to every household | Hands-on exam, lift assist, wound care in the home |
| City staff load | High. This is an EMS product line | Low after launch |
Where the work splits
- Community paramedicine: frequent 911 callers with a care plan, post-discharge CHF checks, patients who failed phone contact, scenes that still need a responder.
- Resident telehealth: the rest of the city, including uninsured households, when they would have dialed 911 for a non-emergency.
A large share of emergency-department visits are treated and released; see CDC NCHS Emergency Department FastStats. Paramedicine cannot absorb that volume house by house; telehealth cannot close cases that need a person in the room.
What goes in the packet?
Observed, Ferris, Texas (resident telehealth, not CP): 20 percent fewer non-emergent EMS runs, more than 50 percent resident adoption, City Manager Brooks Williams. Not a community-paramedicine result.
Observed, TAP: 93 percent of encounters resolved without another claim. 9.9/10 resident rating.
Modeled, EMS side: $450 to $900 per avoided non-emergency response, municipal cost-to-serve. It fits calls that never go out; price CP with your overtime rate, vehicle cost, and visit count.
If a vendor shows a CP study from another state, check whether it counted scheduled visits or 911 reductions. Different numbers.
Should we staff CP, buy telehealth, or both?
Staff CP if you have a frequent-caller list and a medical director who will sign protocols. Buy resident telehealth if you want citywide coverage without hiring. Buy both if the medic team stays small and aimed at hard cases.
Do not stand up a CP unit to avoid a telehealth contract; you will spend the team on sore throats. Do not tell the fire union that telehealth replaces their jobs. Lift assists, trauma, and true emergencies stay on the truck.
Ask for a scoped estimate
Send 12 months of medical 911 volume and any frequent-caller list. TAP will price resident telehealth and leave CP staffing on your side of the page.
Request a local EMS savings estimate
Last reviewed: September 2026.
