CMS taps participants for new ambulance crew payment model

An ambulance drives through winter weather
The Centers for Medicare & Medicaid Services has named participants in its new ambulance payment model. (Getty Images/gmcoop)

The Centers for Medicare & Medicaid Services (CMS) has tapped more than 200 participants for its new payment model for emergency transport that aims to pay ambulance crews even if they don't take a Medicare patient to the hospital.

CMS unveiled the five-year model a year ago. The goal is to reduce the incentive for an emergency response team to take patients to the hospital unnecessarily, which can balloon costs.

The Emergency Triage, Treat and Transport (ET3) model participants represent 36 states and the District of Columbia.

Under the model, CMS will pay participants when they transport patients to an alternative site, such as a primary care office or urgent care clinic, or if a qualified practitioner provides care either on-scene or using telehealth.

CMS Administrator Seema Verma said the model will allow ambulance crews to provide the right care in the right place to a patient.

“Most beneficiaries who call 911 with a medical emergency are transported to a hospital emergency department, even when a lower-acuity destination may be more appropriate,” Verma said.

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Patients can still request to be transported to the hospital if they prefer.

When the model was first announced, CMS estimated that it could save as much as $1 billion, because 19% of traditional Medicare beneficiaries could be treated at home by an ambulance crew or in a less costly facility in an emergency.

Then-Center for Medicare and Medicaid Innovation Director Adam Boehler said the new program could save first responders 45 minutes per visit, freeing up 50 million minutes of emergency response time per year.

CMS said that all of the participants in ET3 signed on to provide the alternative transportation sites, but the agency did not specify how many have signed on for the telehealth portion of the program.

Alongside unveiling the participants, CMS said it will begin accepting applications this summer for another model, in which state or local governments that sign on to a two-year agreement to test a medical triage line. There will be 40 such arrangements made available.