Without insurance changes, CP programs will be on life support

Medicare and Medicaid must change reimbursement policies to keep community paramedicine programs from collapsing

North Carolina’s alternative destination pilot program is just one of the increasing number of community paramedicine (CP) programs that have launched across the country in the past four years.. Initially greeted with skepticism, our industry has begun to embrace the concept of providing appropriate, nonemergent interventions while maintaining emergency response readiness. 

These projects have ranged widely in scope, from alternative transport destinations to post-discharge follow-up care. Health care systems see the potential in reducing the overall cost of care, while EMS builds a stronger foundation to maintain services.

Still, what all of these pilot projects have in common is huge - none of it is currently reimbursable by the Centers for Medicare and Medicaid Services (CMS). These projects have been funded by grants and other sources of government funding. Without reimbursement, these projects run the risk of collapse. Sadly, it takes time for CMS to deliberate on the results of these projects and determine if they are worthy of insurance payments. 

The problem is, CMS already doesn’t cover the cost of emergency ambulance care. Both private and publicly-based EMS systems are struggling to stay afloat as CMS reimbursement continues to dwindle. Pay remains low throughout the industry, and despite the effort to complete the training and enter the profession, many still leave much too early. 

Let’s hope that we’ll see a redirecting of health care monies toward EMS soon. Without it, all of the great CP work being done by EMS systems across the country will be for naught. In fact, we might be going on life support ourselves.

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