1.Decoupling Payment from Transportation a. Local EMS authorities / agencies should:
f. Payers should: i. Reimburse EMS for the successful performance of evidence-based clinical processes proven to improve patient outcomes. 2.Reimbursement Through Telehealth a. Local EMS agencies / authorities should: i. Develop the capabilities to transmit real-time video and audio from the field to a physician or other clinical provider for both routine direct medical oversight and potentially reimbursable telehealth encounters. b. State legislatures & Medicaid committees should: i. Amend laws and/or policies to allow for reimbursement for telehealth encounters that originate in the ambulance or in the field facilitated by EMS providers. c. Payers should: i. Reimburse EMS providers for arranging,
i. Envision and begin making the structural and process changes necessary to be successful in a value-based payment system. ii.Consider collaborative relationships with other community health care stakeholders. iii. Modify protocols or policies that require transport to the emergency department. b. Community & civic leaders should: i. Convene discussions and foster collaborations between EMS and other public health, public safety, and community health care stakeholders. ii.Support the piloting of resulting innovative programs. c. State EMS authorities / associations should: i. Modify protocols or policies that require transport to the emergency department. ii.Advocate for EMS representation on state committees related to health care finance and reimbursement. d. State Medicaid and other health policy committees should: i. Include EMS representation. ii.Allow for EMS reimbursement for response and treatment, independent from transportation. iii. Involve EMS in quality improvement organization (QIO) activities. iv. Engage other payers to create multi-payer reimbursement agreements. e. National EMS associations should: i. Continue to advocate in a unified way for the decoupling of reimbursement from transportation across all public and private payers. ii. Advocate for payments based on medically appropriate services provided regardless of whether or not the patient is transported to an emergency department.
coordinating, and/or participating in telehealth- enhanced clinical care in the field, independent of transportation.
3. Improving Business & Technical Capabilities a. Local EMS agencies / authorities should: i. Cultivate greater business and management skills. ii.Acquire greater financial and technical
capabilities to understand costs, support data management, and better inform financial and operational decision-making. iii. Improve analytic skills to prove outcomes and value for individual patients and across populations. iv. Develop and deploy patient satisfaction measurements to better understand our current service and measure the effectiveness of new processes. v. Promote an innovative and entrepreneurial culture within the agency.
MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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