CMS launches new model for paying ambulance crews-even if they don't transport to the ER

CALAAEM News Service at
Thu Feb 28 09:34:26 PST 2019


Feb. 28, 2019


CMS launches new model for paying ambulance crews-even if they don't
transport to the ER



&utm_source=internal> FierceHealthcare


by Paige Minemyer | Feb 14, 2019 2:51pm


The Trump administration is launching a new model that would pay first
responders even if they opt not to take a patient to the hospital. 


The Emergency Triage, Treat and Transport (ET3) model will pay first
responders when they transport patients by ambulance to urgent care or their
primary care provider, and will also cover care provided by EMS onsite,
either in-person or through telehealth. 


Department of Health and Human Services Secretary Alex Azar said at a press
conference Thursday afternoon that the goal of the model is to end the
incentives for first responders to transport patients to the emergency room,
where care is more costly and can take longer. 


And in the bigger picture, the model is a "signal to everyone involved" that
it's possible to rethink where patients traditionally receive care, Azar


"Together, this effort is going to save lives and it's going to improve the
quality of care in our system," he said. 


Adam Boehler, director of the Center for Medicare & Medicaid Innovation
who's shepherding the model, said at the conference that Medicare
beneficiaries' copayments for ambulance transport will remain the same
regardless of where they're taken, but they will see savings in avoiding
costly ER care. 


Centers for Medicare & Medicaid Services Administrator Seema Verma said at
the press conference that the model could save the healthcare system $1
billion in avoidable ED costs, as 19% of Medicare fee-for-service
beneficiaries could be treated at home or in another, cheaper facility for
their emergency needs.


Boehler said the model could also save 45 minutes of emergency response time
for a visit, which expanded across the Medicare population alone would save
first responders 50 million minutes per year. And in many emergency
situations-such as for patients having a heart attack or stroke-every minute
counts, he said.


"That will directly translate to into thousands of saved lives," Boehler


Patients who want to be transported to the ER will still have that option,
too, he said.


Boehler said that EMS providers that choose to participate in the model will
have options in how they wish to structure the on-site element.  


Some may choose a telehealth-heavy model, where a doctor or other advanced
practice clinician provides care via remote monitoring, and some may instead
choose to have a physician or nurse practitioner who travels to the
emergency scene. 


CMS is hoping that Medicaid and private payers also take an interest in the
voluntary model, Verma said. Boehler said CMMI is looking to test the ET3 in
about 30% of the Medicare population, beginning as early as 2020. 


The demonstration would last for five years, according to a fact sheet from
CMS. CMS will begin accepting applications for Medicare-participating
ambulance services and EMS providers this summer.



Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service


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