Abstract An academic medical center and emergency medical services system collaborated to implement a community paramedicine program. The objectives of the program are to reduce 30-day unplanned hospital readmissions, emergency department, and 9-1-1 system use, and overall health care cost. Multidisciplinary team members collaborate to identify social determinants of health for a vulnerable population, largely ill defined by health care administrators and clinicians. The focus for nurse practitioners is to assist patients to engage in health behaviors that improve and sustain health habits to prevent disease and decrease mortality and morbidity. The economic drive is to improve value and patient care.