CMS announces Medicare reimbursement for certain non-transport treatment
The Emergency Triage, Treat and Transport Model makes Medicare reimbursement available for treatment without transport
Industry experts react: read what members of the EMS1 Editorial Advisory Board have to say about the newly announced Emergency Triage, Treatment and Transport (ET3) reimbursement model here and learn more about the latest ET3 news, analysis and reactions on what ET3 means for EMS reimbursement, billing and value-based care here.
By News Staff
WASHINGTON — A new payment model was announced Thursday that will make Medicare reimbursement available for certain non-transport ambulance services and ambulance transports to alternate destinations.
Officials from the Centers for Medicare and Medicaid Services, the U.S. Department of Health and Human Services announced the Emergency Triage, Treat and Transport (ET3) Model at a DC Fire & EMS station.
“This model will create a new set of incentives for emergency transport and care, ensuring patients get convenient, appropriate treatment in whatever setting makes sense for them,” said HHS Secretary Alex Azar. “Today’s announcement shows that we can radically rethink the incentives around care delivery even in one of the trickiest parts of our system. A value-based healthcare system will help deliver each patient the right care, at the right price, in the right setting, from the right provider.”
The ET3 Model will make it possible for participating EMS agencies to partner with qualified healthcare practitioners and providers to deliver treatment in place (on-scene or via telehealth) and with alternative destination sites (such as primary care doctors’ offices or urgent-care clinics)
HHS officials note that ET3 Model is designed to engage healthcare providers across the care continuum to more effectively meet beneficiaries' needs.
The Model, which will have a five-year performance period, will also encourage medical triage lines for low acuity 911 calls.
Officials have released the following details on ET3:
- CMS is anticipating a start date of early 2020
- The Model will apply only to agencies that respond to 911 calls
- Ambulance agencies currently enrolled as Medicare providers can apply to participate beginning this summer
- This is a voluntary program — reimbursement under the standard ambulance fee schedule won't change for now
- Participating EMS agencies will need to track designated quality metrics
Currently, Medicare primarily pays for unscheduled, emergency ground ambulance services when beneficiaries are transported to a hospital emergency department. This often creates an incentive to transport patients to the hospital, even when an alternative treatment option may be more appropriate.
CMS plans to release a Request for Applications this summer to solicit Medicare-enrolled ambulance suppliers and providers.
This fall, CMS will issue a Notice of Funding Opportunity to implement the triage lines for low-acuity 911 calls in limited two-year cooperative agreements.
We’ve received positive feedback on the ET3 model, as it seeks to engage #healthcare providers across the care continuum to more appropriately & effectively meet beneficiaries’ needs & encourage development of medical triage lines for low-acuity 911 calls. https://t.co/vYF3cnplS0 pic.twitter.com/pBPIzgpXDy— Administrator Seema Verma (@SeemaCMS) February 14, 2019
ET3 seeks to realign Medicare’s incentives so we can cut down on those surprise bills and make sure beneficiaries are getting appropriate care at the right time and place. https://t.co/vYF3cnplS0 pic.twitter.com/jp09N0Qur5— Administrator Seema Verma (@SeemaCMS) February 14, 2019
The Emergency Triage, Treat & Transport (ET3) model will make it possible for participating ambulance suppliers & providers to partner w/ qualified healthcare practitioners to deliver treatment on the scene and with alternative destination sites. https://t.co/vYF3cnplS0 pic.twitter.com/hkLwU16ITG— Administrator Seema Verma (@SeemaCMS) February 14, 2019
.@CMSinnovates is excited to announce the Emergency Triage, Treat & Transport model for emergency ambulatory services, aiming to allow #Medicare FFS beneficiaries to receive the best level of care at the right time & place, w/ potential for lower costs! https://t.co/WgJyzM8vih pic.twitter.com/m3rX0b3QpG— Administrator Seema Verma (@SeemaCMS) February 14, 2019
LIVE! from DC FD Station 13 for breaking news from high level HHS and CMS officials on a new model for ambulance reimbursementPosted by Page, Wolfberg & Wirth on Thursday, February 14, 2019
The new 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)— Jose Cabanas (@cabanasmd) February 14, 2019
Current incentives for emergency #ambulance ground transportation offer limited approaches for value-based care. The Emergency Triage, Treat, and Transport (ET3) Model provides new options for improved care delivery. https://t.co/5HI8QhrYFb— Adam Boehler (@AdamCMMi) February 14, 2019
CMS’s @SecAzar and @SeemaCMS announce the new #EMS Emergency Triage, Treat, and Transport (ET3) program. This program paves the way for the future of #mobilehealthcare by helping connect patients with the right care at the right place & time #CommunityParamedicine @CMSinnovates pic.twitter.com/W0TBBpTwBB— AmericanAmbulanceAsn (@amerambassoc) February 14, 2019