Health care – Dr. John Wells

Brownsville MIH Program Provides Focused Care to CHF Patients

Dr. John Wells serves as the medical director of fire and emergency medical services (EMS) for the City of Brownsville in Texas. In this role, Dr. John Wells focuses on providing the best emergency care possible to the residents of Brownsville and continues to innovate with new programs. Last year, the city announced the start of the Mobile Integrated Health (MIH) program, which reduces strain on emergency providers while improving interventions and outcomes.

MIH targets people who frequently call 911 and offers an alternative way of providing non-urgent care. Through the program, paramedics conduct regular welfare checks in the individual’s home to evaluate personal health and living environment. Then, the provider connects individuals to the right resources to get the proper care.

In Brownsville, the MIH program is serving individuals with congestive heart failure (CHF) who were recently discharged from the hospital. Readmission rates for patients with CHF are high in the first 30 days after discharge and the average cost is about $10,000. By sending paramedics to evaluate patients, care is improved while money is saved. The city hopes to expand its MIH program to a variety of other diagnoses in the near future.

Important Features of a Mobile Integrated Health Program

Brownsville, Texas-based, Dr. John Wells is the CEO of Melchizedek Medical and works with the City Health Authority in a leadership role. As the medical director of fire and EMS services, Dr. John Wells participated in the structuring and implementation of a Mobile Integrated Health (MIH) program in Brownsville in 2019.

An MIH program, at its core, aims to provide patient-centered healthcare services in an outpatient environment to reduce the number of emergency service users. A key component of any MIH program is full integration within the existing healthcare system. It should function as an extension of the services offered by facilities in the area.

Moreover, an MIH should respond to specific needs within a community. If the program cannot address the requirements of local stakeholders, it will fail to reduce the incidence of EMS users. The goal should be to fill specific gaps in the local community.

And, it’s important that any effort toward mobile care be driven by data. By collecting and examining performance metrics, program leaders can ensure that the program is having the intended outcome.

The ET3 Model – An Overview

An MBA graduate in health service management from Texas Tech University – Rawls College of Business, Dr. John Wells, MD, is medical director of Fire/EMS for the City of Brownsville, Texas. In that role, Dr. John Wells integrates experiences from health services management and emergency medicine to develop medical policies in line with federal and state guidelines. Under his leadership, the department has expanded programs, and recently earned acceptance into the ET3 program.

An abbreviation of Emergency, Triage, Treat, and Transport, ET3 is a voluntary payment model developed by the Centers of Medicare & Medicaid Services (CMS) to equip ambulance care teams with flexibility in addressing the emergency health needs for beneficiaries of Medicare Free-for-Service (FFS).

Currently, Medicare regulations allow payment for emergency ambulance services only when individuals are transported to dialysis centers, hospitals, skilled nursing facilities, and critical access hospitals. The ET3 model was developed to avoid unnecessary transport of patients to those facilities in situations where lower-acuity destinations are more appropriate.

With a five-year duration, the ET3 model will enhance the quality of care and minimize expenditures through the following means:

1. Provision of suitable, person-centered care for FFS beneficiaries.

2. Increase efficiency in the current EMS system, so acute cases such as strokes and heart attacks can be responded to in a more timely fashion.

3. Optimize the appropriate utilization of emergency care services.