Multistakeholder perspectives of a managed care-funded community paramedicine programme

Background Community paramedicine (CP) programmes extend traditional paramedic care by delivering scheduled healthcare and social services to high-risk individuals. Research is needed on the perspectives of patients, families, and providers, and their relational dynamics in managed care CP programmes. Methods This qualitative study evaluated a CP programme funded by Molina Healthcare of Texas, a managed care organisation. We conducted interviews with 21 programme members and four significant others and held a focus group with paramedic providers. Data were analysed using reflexive thematic analysis, interpreting across three stakeholder groups. Results Four themes described members’ journey through the programme: (1) Opening the Door and Accepting Help; (2) Building Trust through Support and Navigation; (3) Finding Connection and Belonging through Human-Centred Care; and (4) Reaching the Limits of Support. These themes form a Wheel of Relational Care, illustrating how consistent, personalised work helps open the door to care, build trust, foster connection, and illuminate the practical limits of support across the programme journey. Conclusion CP programmes, under managed care, can meaningfully support high-risk members with their personal needs and improve access to needed services. However, these programmes require substantial staffing and resources for long-term scalability.