THE STICKER SHOCK FELT BY patients getting a bill for an ambulance ride is a problem that has plagued
healthcare for years. A number of factors beyond the control of the patient—who, after all, is being treated for an
emergent condition—results in an inefficient and expensive utilization of resources.
Now, however, the Centers for Medicare and Medicaid Services (CMS) is taking a big step in addressing this issue—for Medicare beneficiaries, at least—in a new pilot program out of the Center for Medicare and Medicaid
Innovation. The value-based Emergency Triage, Treat and Transport (ET3) model will make it possible for participating ambulance suppliers and providers to partner with qualified healthcare practitioners to deliver treatment
in place (either on-the-scene or through telehealth) and with alternative destination sites (such as primary care
doctors’ offices or urgent-care clinics) to provide care for Medicare beneficiaries following a medical emergency
for which they have accessed 911 services, according to a CMS press release. 1 The program would give individuals
more choice on where an ambulance takes them, when appropriate, instead of automatically heading to the near-est costly hospital emergency room.
Although it’s only a pilot project now, if implemented it could save Medicare over $500 million per year and allow local fire departments and ambulance services to focus the time and energy of first responders on the most
serious emergencies, according to the Associated Press. 2
Like other value-based care programs, the ET3 model will eventually involve quality measures, reimbursement incentives, and telehealth consultations, requiring the assistance of health information management
Currently, Medicare only pays ambulance fees for patients taken to a hospital in most cases, although transportation to rehab centers or nursing homes as well as dialysis facilities is also permitted.
So far, the proposed program is being welcomed by healthcare advocates. “We definitely think this is intriguing
and exciting, but it really does need to be monitored very closely,” Julie Carter, a federal policy expert with the
Medicare Rights Center, told the Associated Press. “We see this as a potential opportunity to keep people out of
the ER when they don’t need to be there.” ¢
1. Centers for Medicare and Medicaid Services. “HHS launches innovative payment model with new treatment
and transport options to more appropriately and effectively meet beneficiaries’ emergency needs.” Press
2. Alonso-Zaldivar, Ricardo. “Medicare ambulance rides may no longer end up at ER.” AP News. February 14,
Value-Based Care Now Includes