and EMS organizations (whether fire-based or non-affiliated) for equipment and training, new operational and interoperability initiatives, and to support community resilience. 66 Many EMS innovative models could in part or in full qualify for this funding mechanism. Once an appropriate grant mechanism has been identified, developing a successful application can be overwhelming without experienced grant writers, or samples of successful applications. State and national EMS associations should try to provide technical assistance for EMS agencies pursuing these programs. It’s also true that not every innovation needs to be scientifically or otherwise proven to be valuable before being piloted in the marketplace. Even within health care, many care coordination efforts, clinical innovations, and educational initiatives are pursued by organizations large and small without external funding. EMS agencies should consider internally funding pilots that are likely to have little immediate detrimental financial impact.
COMBATING FRAUD & ABUSE EMS leaders should take more aggressive action to reduce or eliminate fraud within the industry, thereby improving allocation of precious resources and enabling innovation. EMS agencies both large and small could possibly work to improve compliance with documentation and billing practices. Maybe state EMS authorities could provide assistance and guidance. Perhaps major industry organizations could partner with CMS, other federal authorities, and payer groups to form a task force to design and implement anti-fraud and abuse initiatives. Together, they may also be able to drive testing of alternative economic models that could reduce the perverse incentives associated with fee for service reimbursement that may contribute to fraud and abuse. Undertaking this challenge would communicate the industry’s willingness to work collaboratively to combat the fraud and abuse issues in the ambulance industry which may in turn advance conversations about decoupling payment from transportation.
66 “Assistance to Firefighters Grant Program.” FEMA . Last modified June, 26, 2017. https://www.fema.gov/welcome-assistance-firefighters-grant-program
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MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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