Applicants selected to participate in ET3 payment model
The Centers for Medicare & Medicaid Services has selected 205 applicants to test the program for five years
By Laura French
BALTIMORE, Md. — The Centers for Medicare & Medicaid Services (CMS) has announced the selection of 205 applicants to participate in the Emergency Triage, Treat, and Transport (ET3) Model, a new payment model that allows services to be reimbursed for non-hospital transports.
The program is designed to reduce costs to Medicare while allowing more flexibility for ambulance services to make transports to facilities such as urgent care centers, which are not reimbursed under the current model.
“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,” said CMS Administrator Seema Verma. “The participants in our ET3 Model will be able to deliver care to patients at the right time and place. We congratulate the applicants selected to participate in the Model, and we look forward to working with them on testing new payments for emergency transport to improve patient care.”
In addition to receiving payment for transporting patients to alternative destinations such as urgent care centers or doctor’s offices, services can also be reimbursed for initiating and facilitating treatment in-place through a qualified health care practitioner, either in-person or via telemedicine. Emergency transports to hospitals will continued to be reimbursed as usual, and patients can always choose to be transport.
As another component of the Model, CMS intends to issue a Notice of Funding Opportunity (NOFO) for up to 40 two-year cooperative agreements, available to state and local governments, or their designees that operate or have authority over a Primary or Secondary Public Safety Answering Point (PSAP) that receives 911 calls in geographic regions where ambulance suppliers and providers are participating. The NOFO will fund the implementation of a medical triage line integrated with the PSAP in an eligible region. The Model will test whether these two components will work synergistically to improve quality and lower costs by reducing avoidable transports to the ED and unnecessary hospitalizations following those transported to a hospital if preferred, according to CMS.
Selected applicants are expected to begin implementing the program in the spring of 2020, when a full list of participants will become publicly available. CMS is currently notifying those selected to participate so they can prepare by beginning to form partnerships with alternative transport destinations and other healthcare professionals.
Learn more: https://www.ems1.com/et3/