If I had to guess (as a BLS medical transport and EMS provider), this is probably more a case of AMR responding to what are essentially 911 calls that are called to their dispatch, rather than simply providing "paramedic" services. I don't know how you can even separate paramedic from CCT skills, unless they are starting lines or dropping tubes. I've run a few calls where I transported non-emergent patients to ERs, but our company has permission to do that in a few of the counties we run, and they are always pre-arranged transfers (we don't choose the ER we're going to) nonetheless.