Washington DC continues to struggle with whether to repeal and replace Obamacare while other, less-known policy changes may have an impact on the emergency medical services (EMS) community, how it manages its businesses, and how it delivers care to patients. There are several issues to be aware of regarding how changes in the health care laws may affect EMS. EMS may need to adapt to new reimbursement policy changes and may eventually participate in programs that pilot new reimbursement models. Some possible changes on the horizon for EMS include:
- Bundled payments: The Centers for Medicare and Medicaid’s proposed rules include new episode payment models, and require health care providers to understand all costs associated with treating patients with acute care conditions. The new rules, which have been delayed until January 2018, give hospitals incentives to measure outcomes, rather than simply pay for procedures, tests and services provided.
- Risk-based payment: Providers may be expected to either receive lower fee-for-service rates or take on greater risk to provide care for a designated population for a set fee.
- Quality control documentation: EMS and other providers may need to work closely with electronic health record vendors to ensure the reliability and reporting of services provided, to avoid penalties and reduced payments under some of the new reimbursement models.
- Medicare fee schedule: The temporary Medicare fee schedule for ambulance services is scheduled to expire at the end of 2017. It is unclear whether the fee schedule will be made permanent or if there will be approval of another long term extension.
- Supplier vs. provider: There continues to be a push to shift ambulance services from suppliers of medical transportation to providers of health care, which could result in greater reporting requirements for quality control, required standards of care, and value-based payments.
- Funding for alternative models: Policymakers and payors continue to focus on increasing preventive care and decreasing hospital admissions. This could result in increased coverage for mobile integrated health care, and expansion of alternative transport destinations.
The EMS community will need to focus on improving the quality of care by looking for ways to improve efficiency and innovation, and by adapting and responding to the changes ahead in the delivery of health care.
Source:”5 changes to health care and how they impact EMS,” by Roxanne Shanks, Fitch & Associates, June 2017, EMS1.com
Medtrust Transport provides emergent and non-emergent ambulance services in Charleston, Myrtle Beach and Georgetown, South Carolina. We have trained EMT personnel and a fleet of fully-equipped ambulances. We aim to provide compassionate and timely patient care.