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ET3: Don’t let this be the final word

Turning frustration into action as the end of ET3 puts a wrench in treatment in place, alternate destinations

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“My first reaction was, what the hell. My second reaction was, well, I guess if there’s not going to be any participation agreement, then we’re not bound by confidentiality anymore, and I’ll just email the Booz Allen presentation to every member of Congress, and say, ‘here’s the savings to the Medicare program, please pass the TIP and TAD language. And I honestly think we should do that, and we probably will.” — Matt Zavadsky

In this crossover episode of Inside EMS and EMS One-Stop, Matt Zavadsky, MS-HSA, EMT, chief transformation officer at MedStar Mobile Healthcare (an ET3 participant), joins cohosts Chris Cebollero and Rob Lawrence to discuss the recently announced end of the ET3 program.

Top quotes from this episode

  • “That must be a mistake … I was just dumbfounded, absolutely dumbfounded.” — Matt Zavadsky
  • “We can’t stop this – we’ve got to continue to move this along somehow and ensure that we’re still doing the things we need to do for our patients.” — Chris Cebollero
  • “It doesn’t take a rocket scientist to figure out that if we don’t bring everybody to the hospital, that the patient benefits; Medicare benefits.” — Matt Zavadsky
  • In the last 2 years, “55 systems have closed and growing … because the economic model is jacked up. Until we as a profession do what nurses did, do what doctors do, to show that our value is not transactional; our value is transformative … our days are numbered.” — Matt Zavadsky
  • “Continue to do what you do while we try to sort out this mess, because we thought we were on the right route, and then someone’s now put out a roadblock, so we have to work out how to detour or indeed knock it down. Keep up the good work while we try to work out how to get around this.” — Rob Lawrence
  • “We as a profession cannot let this be the final word.” — Matt Zavadsky

In addition to why CMS didn’t see the savings they were anticipating, and the hoops agencies had to jump through to participate in the ET3 program, the group focuses on what’s next for reimbursement reform.

Together, they discuss:

  • How the national associations (NAEMT, AAA, IAFC, IAFF) are working to get legislation introduced in Congress to get treatment in place and transport to alternate destinations (TIP and TAD) covered
  • The need for data from organizations that participated in the ET3 model that proves the cost savings
  • Admittance avoidance vs. arrival avoidance at the ED
  • Turning frustration with Medicare into action
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The Inside EMS podcast is a regular expert discussion of hot topics, clinical issues, operational and leadership lessons for EMTs, paramedics and chiefs