Alternative Pathways to Care: The Massachusetts Experience
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EMS systems around the US have historically been incentivized by Center for Medicare and Medicaid (CMS), private insurers and other payers to transport all patients encountered through accessing 911 emergency call systems, to an acute care facility emergency department (ED). The reimbursement model for ambulance services in place currently only provides payment for transport of any patient to a state licensed ED according to CMS. The changing healthcare system in the US, through the Affordable Care Act (ACA) 2010, looks to healthcare systems and contractors to provide healthcare at a lower cost. CMS is prescribed, as part of the ACA, to test innovative delivery models to reduce program expenditures…while preserving or enhancing quality of care furnished to individuals.”
This session will review the concepts and programs of implementing a modified system of care whereas trained EMS providers, under the supervision of a physician Medical Director, can transport patients experiencing a psychiatric emergency or require drug abuse services to a destination other than the acute care emergency department. This session also will review existing research papers, conclusions and data available for several existing programs for EMS utilization of permissive alternative destination for behavioral and mental health patients and patients requiring services for drug or alcohol use, in the absence of any acute medical condition.