Mid-Term Election Analysis Webinar

Join AAA Government Affairs Committee Chair, Jamie Pafford-Gresham, AAA SVP of Government Affairs, Tristan North, AAA Senior Manager of Federal Affairs, Ruth Hazdovac, and Manager of State & Federal Government Affairs, Aidan Camas, as they provide a brief re-cap of the recent mid-term elections. This pre-recorded webinar provides an update on federal and state election results, and how they may impact our industry. We review possible leadership changes in the House & Senate as well as on key committees of jurisdiction over ambulance related legislation. The webinar also provides a brief look ahead into AAA legislative priorities for 2019. If you have any questions about material covered on the presentation, please email Aidan Camas at acamas@ambulance.org. ►Watch the video on Youtube here...

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Mid-term Election Analysis

As a result of Tuesdays’ elections, Democrats will control the U.S. House of Representatives next Congress and Republicans will have a larger majority in the United States Senate. Presently, Democrats have gained a net of 30 seats in the House with Republicans netting two seats in the Senate. Democrats needed to capture 23 seats from Republicans to gain the majority. There are still several races in the House and Senate to be called which will likely add to those totals. Akin Gump, the lobbying firm for the AAA, has put together a synopsis of the election results as of this morning and a slide deck on historical trends and the outcome of races called so far. Key supporters of the industry who will not be returning next Congress include Representatives Peter Roskam (R-IL), Mike Coffman (R-CO) and Erik Paulsen (R-MN). All three members have been supportive of ambulance initiatives with Roskam in his position as Chair of the House Ways and Means Health Subcommittee and Paulsen as a member of the Subcommittee. Coffman sponsored legislation to apply the prudent layperson definition to emergency ambulance services provided to veterans. In late breaking news, the Senate race in Montana was called in favor for (more…)

2017 National and State-Specific Medicare Data

The American Ambulance Association is pleased to announce the publication of its 2017 Medicare Payment Data Report. This report is based on the Physician/Supplier Procedure Summary Master File. This report contains information on all Part B and DME claims processed through the Medicare Common Working File and stored in the National Claims History Repository. The report contains an overview of total Medicare spending nationwide in CY 2017, and then a separate breakdown of Medicare spending in each of the 50 states, the District of Columbia, and the various other U.S. Territories. For each jurisdiction, the report contains two charts: the first reflects data for all ambulance services, while the second is limited solely to dialysis transports. Each chart lists total spending by procedure code (i.e., base rates and mileage). For comparison purposes, information is also provided on Medicare spending in CY 2016. Questions? Contact Brian Werfel at bwerfel@aol.com.  ...

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President’s Perspective October 2018

Dear Fellow AAA Members, Since I assumed the office of president last month at our Annual Conference, I have been deeply moved by the selfless actions of ambulance services across the nation as they responded to natural disasters. As always, EMS answered the call to help with humanity, efficiency, and professionalism. My thoughts are with those impacted by the recent storms as well as the thousands of EMTs and Paramedics currently helping with Hurricane Michael recovery. Annual Conference & Trade Show Thanks to each of you who attended, exhibited at, or sponsored this year’s impressive Annual Conference & Trade Show. We appreciate your support and participation—it could not have been such a success without you. Once again, congratulations to our AMBY and AAA award winners! I would also like to welcome our new board members and thank those who continue to serve. At the conference, I took a few minutes to share my thoughts about the future of our association. If you missed it, you can catch up via video or essay on the AAA site. We can’t wait to see you in Nashville next November 4-6, 2019! Please check back at www.annual.ambulance.org early next year for more attendee information....

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MedPAC Examines Beneficiary Use of Emergency Departments

During its October meeting, the Medicare Payment Advisory Commission (MedPAC), reviewed Medicare’s current policies related to non-urgent and emergency care, as these topics relate to the use of hospital emergency departments (EDs) and urgent care centers (UCCs). The Commission is examining this topic because the use of ED services in recent years has grown faster than that of physician offices.  At the same time, the share of ED visits that are coded as high acuity has increased. The Commission is exploring Medicare beneficiaries’ use of EDs and UCCs for non-urgent services. In addition, the Commission is analyzing ED coding to determine if the increase in coding high-acuity visits reflects real change in the patients treated in EDs. This slide deck shows the potential savings Medicare could realize if beneficiaries shift certain care to the UCC setting. During the meeting, the staff sought feedback from Commissioners for developing next steps. This topic will likely continue to be addressed in future meetings. From the perspective of ambulance payment reform, the observations made by the Commissioners and staff would also seem to support incorporating scope-appropriate ambulance services in the context of community paramedicine or treatment at the scene with referral. While additional work...

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Talking Medicare: CMS Implements Further Dialysis Cuts

Talking Medicare: CMS Implements Further Cuts in Reimbursement for Dialysis Services; Medicare Payment Data Shows Continued Reduction in Overall Spending on Dialysis Transports, but Net Increase in Dialysis Payments in Prior Authorization States On October 1, 2018, CMS implemented an additional thirteen (13%) cut in reimbursement for non-emergency BLS transports to and from dialysis. This cut in reimbursement was mandated by Section 53108 of the Bipartisan Budget Act of 2018. This on top of a ten (10%) cut in reimbursement for dialysis transports that went into effect on October 1, 2013. As a result, BLS non-emergency ambulance transports to and from dialysis that occur on or after October 1, 2018 will be reimbursed at 77% of the applicable Medicare allowable. The payment reduction is partially the result of the reduction in the amounts paid for dialysis services. However, it is also reflective of an overall decline in the number of approved dialysis transports. For this, we can look primarily to the impact of a four-year demonstration project that requires prior authorization of dialysis transports in 8 states and the District of Columbia. As a reminder, the original prior authorization states were selected based on higher-than-average utilization rates and high rates of...

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Preliminary Calculation of 2019 Ambulance Inflation Update

Section 1834(l)(3)(B) of the Social Security Act mandates that the Medicare Ambulance Fee Schedule be updated each year to reflect inflation.  This update is referred to as the “Ambulance Inflation Factor” or “AIF”. The AIF is calculated by measuring the increase in the consumer price index for all urban consumers (CPI-U) for the 12-month period ending with June of the previous year. Starting in calendar year 2011, the change in the CPI-U is now reduced by a so-called “productivity adjustment”, which is equal to the 10-year moving average of changes in the economy-wide private nonfarm business multi-factor productivity index (MFP). The MFP reduction may result in a negative AIF for any calendar year. The resulting AIF is then added to the conversion factor used to calculate Medicare payments under the Ambulance Fee Schedule. For the 12-month period ending in June 2018, the federal Bureau of Labor Statistics (BLS) has calculated that the CPI-U has increased by 2.87%. CMS has yet to release its estimate for the MFP in calendar year 2019. However, assuming CMS’ projections for the MFP are similar to last year’s projections, the number is likely to be in the 0.5% range. Accordingly, the AAA is currently projecting (more…)

LifeWorks October Feature: Work-Life Balance and Productivity

October Feature: Work-Life Balance and Productivity Ten Tips for Fitting Work and Life Together Would you like to move beyond feeling stressed or overwhelmed by your personal and work responsibilities? Or learn how to achieve personal and professional success on your own terms? “Knowing how to manage the way work and life fit together is a modern skill set we all need to succeed,” says Cali Williams Yost, an internationally recognized flexible workplace strategist and author of the books Tweak It: Make What Matters to You Happen Every Day and Work+Life: Finding the Fit That’s Right for You. Here are Yost’s 10 strategies: Remember that work-life fit is unique for each of us. “Simply put, there is no work-life balance or perfect 5050 split between your work and your personal life,” Yost says. “If you do happen to hit a balance, you can’t maintain it because your realities are always changing, personally and professionally.” There’s also no “right way” to achieve a good work-life fit. Your goal is to find your unique, ever-changing fit, the way your work and personal realities fit together day-to-day and at major life transitions. Don’t compare yourself to others. Find the fit that’s right for...

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