Study: Redirecting ambulances away from ER could save Medicare millions

The federal government could save $560 million or more a year if Medicare had the flexibility to reimburse emergency medical services (EMS) for managing selected 911 calls other than transport to an emergency room, according to a new study published in Health Affairs. Society could save twice that amount if private insurance companies also had that flexibility, the study found. Researchers examined Medicare claims data from 2005 to 2009 and estimated that as many as 16 percent of Medicare-covered 911 EMS transports involved conditions that were not emergencies or ones that a primary care provider could handle. Among Medicare beneficiaries not admitted to the hospital, nearly 34.5 percent had a low-acuity diagnosis that researchers determined providers outside the ER probably could manage. Annual Medicare EMS and ED payments for these patients were approximately $1 billion per year. Abstract