The Holdsworth Group - July 2019


Since this new trial program was announced by Center for Medicare and Medicaid Services (CMS) on May 22, 2019, the industry has been touting it as the greatest thing ever … but is it? More importantly, can your service participate in this five-year trial program? The Request for Applications (RFA) was announced in May, and applications are expected to be accepted this summer with the initial participants chosen this fall. January of 2020 through December of 2024 will be the performance period. One challenge is the program was released with a very short time frame for applicants to submit eligibility. Most states do not have guidelines to allow for compliance with the program, few have telemedicine established, and all participant groups must have transported at least 15,000 Medicare patients in 2017, so only a few will have the ability to start. The premise behind the program is solid: Let’s try to triage and treat more patients in their homes, transport only when absolutely necessary, and then make sure they get to the best (most cost effective) destination possible.

The five-year test period is only supposed to look at two specific parameters: 1. Payment for transportation to alternative destinations not currently covered by Medicare, and 2. Payment for treatment in place, rendered by an appropriate health care practitioner at the scene via telehealth The overall goals of the initiative are to test a new way to pay for ambulance service by Medicare and Medicaid: • Reduce costs to the program, extending its life • Reduce the burden on overworked 9-1-1 systems and responders • Relieve the pressure on overcrowded emergency departments • Encourage providers/communities to invest in medical triage capabilities On the surface, it looks like a win. To those of us who’ve been around for a while, it’s obvious the initiative may negatively impact small community-based agencies and favor large conglomerate providers. Most states and providers are not ready. While many states have authorized Mobile Integrated Healthcare regulatory guidance

or pilot programs, few have developed policies to allow for transportation to alternative destinations. Telehealth and telemedicine initiatives in EMS are in their infancy. We are all still arguing over the legalities and policies of having cameras in the patient compartments. Only huge private providers and countywide providers have established phone triage capabilities. These all cost money, and few are willing to invest unless they see a sure path to profitability. It will be critical for EMS leaders across the country to keep on top of the reports coming out from these test providers. Their demonstrated successes will eventually become our new reality, and your payment structure will morph from treat-and- transport, to triage, treat, and possibly transport. For more information about this program and to download the RFA document, see the webinar overview or get on the ET3 update mailing list at this link: Innovation.cms. gov/Initiatives/ET3/ and then follow the links on the page.


Hey, everyone! I have exciting news. I have over-the-top, shout- it-from-the-rooftops, wave-your-hands-in-the-air news. Healthy Responders will be going live this month! Tailored specifically to the first responder community to encourage longer and stronger lives, Healthy Responders offers three types of app-based programs you can choose from based on what your goals are, how much time you have to dedicate, and what your budget is. But the best part of all three programs is the app is based on a partnership with Virtual Health, so you can get real live feedback from a nutritionist 24/7. You can communicate with experts who can help build delicious recipes and find sustainable snacks you can take on the job. It also offers access to ample exercise programs depending on your personal

goals. You can even sign up to take exercise classes with a fitness instructor live, or you can participate in classes at your own pace. With a Healthy Responders membership, you’ll have access to nutritional guides, exercise plans, recipes, and your own personal tracker all in one convenient location: your pocket. Taking your own health into consideration while on shift can be extremely difficult. But it doesn’t have to be anymore. Constantly going from hours of boredom to springing to immediate action is hard on the body, so you need to make your own health a priority to stay on top of your game. With Healthy Responders, you can. Go to to check out which program is right for you. If you have any questions, don’t hesitate to let me know!



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