Curbing costs, ER visits: How Tandem 365 works

Kent County

GAINES TOWNSHIP, Mich. (WOOD) — Life EMS Ambulance paramedic Makala Gerard traded her ambulance for an SUV Wednesday for a different kind of medical call.

“How have you been walking? About the same?” Gerard asked 84- year-old Donna VanLaan during her house call. 

“Not too good. My legs are bad,” Donna VanLaan responded.

Like many older Americans, Donna VanLaan and her husband, 85-year-old Mike VanLaan, have had their share of health problems and emergency room visits.

“You always wonder, what should I do? What should I do? I can’t call the doctor,” said Donna VanLaan about the dilemma man older Americans face on a regular basis.

That’s where Tandem 365 comes in.

Four years ago, the VanLaans signed up for the service. Now when they have a medical problem, they call Tandem 365.

Medically-trained dispatchers evaluate the problem over the phone. If they cannot solve it, they send a single paramedic with the same equipment carried on a regular ambulance.

“We always have the default that we can send the cavalry if needed to take care of the person,” added Life EMS Ambulance President Mark Meijer, who serves as Tandem 365’s board co- chair.

Once a month, a paramedic pays a scheduled visit to see how they’re doing.

Tandem 365 began five years ago after care providers noticed a large number of older residents calling 911.

Previously protocol called for sending a fully-staffed ambulance which oftentimes transported the patient to the hospital.

“We knew intuitively that there were some patients that didn’t need a full-blown paramedic response and then being transported to the emergency department,” said Meijer.

And the problem will only continue to grow.

“There’s 10,000 people turning 65 every single day through how many years? The next 30 years?

“There has to be a way to take care of people better,” said Tandem 365 CEO Teresa Toland.

Tandem 365 was the answer. The program also involves social workers and other support systems to identify non-medical concerns. 

“And many times, that’s just helping families come together and make united decisions about what’s needed for their loved one,” said Toland.

Most insurance companies cover the program cost for enrolled seniors, which is about $500 a month.

Comparatively, the average ambulance transport cost is between $500 and $1,000, and that doesn’t include the emergency room bill.  

The people behind the Tandem 365 program say the average health care cost for participants has dropped 30.2 percent and ER visits are down 46.2 percent.

Specialty and outpatients visits have also declined.

“We’re about a 4 percent hospitalization rate. When you compare us to home health care or (a) nursing home, that’s about 66 percent less than what they transport,” said Toland.  

Meijer says Tandem 365 could serve as a model for the rest of the country, as it struggles to provide emergency medical service to “super users,” like the elderly.

Right now, five integrated community paramedic units are part of Tandem 365. A sixth unit is planned.

Integrated community paramedics have expanded roles, assisting with public health, primary health care and preventive services instead of exclusively answering emergency calls.

The Tandem 365 program covers Kent, Ottawa and Allegan counties.

“One of the great things advantage-wise we have is the collaboration amongst health care providers, from the hospital to the paramedic ambulance services to home care… senior communities,” said Meijer.

Aside from curbing costs, the program has also raised the comfort level for many families.

“I love that both my parents can pick up the phone (and) someone will answer. They don’t even have to leave a message, and they can talk to a medical person,” sand the VanLaan’s daughter, Lou Ann Winkle.

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Online:

Tandem 365

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