Tag: Nevada

REMSA’s Tiered System Featured on Aging & Awesome

Recently, Reno’s REMSA launched a tiered response model. The news segment from Aging and Awesome featured below offers a clear explanation about how using a variety of healthcare provider levels for an out-of-hospital medical response is an effective and safe way to help patients access the healthcare they need – which can range from an urgent ambulance transport to the emergency room or access to a telehealth provider.

Great Idea | REMSA’s Thank You Notes Page

Reno, Nevada’s REMSA provides nationally recognized ground ambulance service within Washoe County, Nevada. Don’t miss their amazing new “Thank a Healthcare Provider” page, where members of their community are able to share digital thank you notes with REMSA’s Paramedics, EMTs, telecommunicators, pilots, and nurses as well as administrative and operations staff.

Check Out the REMSA Thank You Page

40 Under 40: Glen Simpson (Community Ambulance – Henderson, NV)

40 Under 40 nominees were selected based on their contributions to the American Ambulance Association, their employer, state ambulance association, other professional associations, and/or the EMS profession.
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Glen Simpson
Director of Special Operations
Community Ambulance
Henderson, NV

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LinkedIn
Nominated by: Janet Smith (Community Ambulance – Henderson, NV)
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Biography:

Since 2016, Glen Simpson, AEMT has been the Director of Special Operations for Henderson, NV based Community Ambulance. Simpson offers event venues and producers his more than 15 years of experience designing special medical standby plans and coordinating their implementation in Southern Nevada. Between the years 2008 and 2012, Glen personally oversaw the further development of special event medical services for his former employer, Medic West Ambulance. In 2012, Glen moved into the Operations Manager position for American Medical Response’s special event medical services in Las Vegas.

Focused on crowd management and employee and patient safety, Glen has successfully earned the repeat business of numerous major events like the Electric Daisy Carnival, Rock in Rio, Route 91 Harvest Festival, and many more. Simpson credits his success to fostering and maintaining excellent relationships with venues, producers, and the public safety officials in Clark County, Nevada. Additionally, Glen’s approach to employee training, his meticulous attention to detail and continual follow-up with venue and event producers has distinguished him as “expert” in the niche field of special event medical services. Glen is a frequent conference speaker regarding Special Event Medical Services. Most recently, Glen spent most of 2018 and 2019 presenting at more than 30 venues in the U.S. and abroad regarding his role during the October 1, 2017 mass shooting at the Harvest Festival held in Las Vegas.

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Reason for Nomination:

Glen has worked tirelessly to influence the international perception of special event medical standby personnel as being much more than a “backpack and a flashlight”. Glen has used the numerous presentations he has given around the world over the last two years to redefine and highlight the essential role that special event medical personnel play during any type of incident (large or small). Additionally, Glen has and continues to present before regional and national venue manager audiences. These executives who are pulled in a dozen different directions when securing crowd-drawing events for their facilities, are urged to reconsider contracting with an ambulance provider for event services just to satisfy an event’s medical standby insurance requirements or as just a box to check.

Glen’s experiences being the manager leading his “boots on the ground” employees during the 1 October 2017 Mass Shooting at the Route 91 Harvest Festival event in Las Vegas influences the work he does today. Glen offers his audiences sound counsel about the importance of good public safety relationships. Glen details the requirements for preparing for anything, treating the injured should violence occur, and for managing the first aid needs of event participants and attendees. Glen and his personnel have also engaged in Stop the Bleed training for event personnel and security forces.

Glen has been published for his account of the 1 October tragedy by JEMS Magazine and by EMS1.com. The New York Times covered Glen’s account of the atrocity and The Las Vegas Sun also recognized Glen and his special event crews. Glen and his special event employees were lauded during the 2018 HealthCare Heroes event in Las Vegas and their 1 Oct. story was covered by the event’s sponsor, Nevada Magazine. Glen and his team were also recognized by the American Ambulance Association at the association’s annual meeting in Las Vegas in 2017. Glen and his employees also received an honorary plaque from Clark County Commissioners for the company’s performance during the 1 October 2017 mass shooting. They were also honored by U.S. Representative Dina Titus whose remarks were read into the congressional record on October 24, 2017. Community Ambulance also received a Certificate of Recognition from the Clark County School District Community Partnership Office and from Henderson, Nevada’s Mayor, Debra March.

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View all of the 2020 Mobile Healthcare 40 Under 40 Honorees

40 Under 40: Adam Heinz (REMSA – Reno, NV)

40 Under 40 nominees were selected based on their contributions to the American Ambulance Association, their employer, state ambulance association, other professional associations, and/or the EMS profession.
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Adam Heinz
Executive Director Integrated Health
REMSA
Reno, NV

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Linked In | Twitter
Nominated By: Alexia Jobson (REMSA – Reno, NV)

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Biography:

Adam Heinz is the Executive Director of Integrated Health for Regional Emergency Medical Services Authority (REMSA) in Reno, Nevada. With an intense focus on leading and engaging teams to provide compassionate, clinically excellent prehospital care, Adam brings 18 years of Emergency Medical Services (EMS) experience to the organization. Having progressed in roles from Paramedic to EMS Supervisor, Clinical Development Manager to Director of Clinical Communications, Adam is now responsible for advancing REMSA’s innovative mobile health care projects. Through collaboration with regional partners, regulators, and elected officials, Adam represents the organization on a local, state, and national level. In addition, Adam overs sees REMSA’s clinical division and its Center for Prehospital Education.

Adam is a proud alumnus of the University of Nevada Reno where he earned a bachelor’s degree in psychology. Currently, Adam is pursuing a Master of Business Administration degree with an emphasis in healthcare leadership. In addition to being a Nationally Registered Paramedic (NRP), Adam is certified as a Nevada State EMS Instructor and as an Advanced Emergency Medical Dispatcher (AEMD).

Currently, Adam serves on the Clinical Practices and Standards, and Mobile Integrated Health Committees of the National Association of EMS Physicians and was recently invited to be on the board of directors for Well Care Medical and Behavioral Health Clinic in Reno, Nevada.

Having given presentations at the PeaceHealth Neuroscience Clinical Symposium and the American Heart Association’s Annual Regional Conference, Adam is considered a leading thinker and advocate for the prehospital and mobile health care industry.

Adam is a lifelong resident of northern Nevada. Adam and his wife Heather, an emergency department registered nurse, have two children, Ella (4) and Bentley (2). Adam, a self-proclaimed “Disneyphile” speaks conversational French, enjoys international travel, and has an interest in the history of medicine.

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Reason for Nomination:

Passionate, articulate, supportive, confident, organized, honest, loyal, and transformational leader are just some of the ways Adam Heinz is described by his colleagues and the leadership at REMSA. Adam has an unyielding commitment to advancing the EMS industry by innovating, leading, and pursuing excellence. Starting as a Paramedic with REMSA 12 years ago, Adam has progressed through leadership positions to his current role as Executive Director of Integrated Health. Along the way, Adam consistently meets or beats budget objectives for his non-profit, non-tax-subsidized employer, implements forward-looking projects such as Alternative Destination Transport and Alpha/Omega protocols, leads groundbreaking initiatives such as REMSA’s AED drone delivery project. Additionally, Adam engages with front-line providers through educational opportunities, hosting EMS skills competitions, and highlighting exceptional care in the field at the weekly medical leadership meeting.

Adam’s contributions range from volunteering to serve on REMSA’s Employee Wellness Action Committee to the more sizable task of successfully leading REMSA’s Clinical Communications Center through two re-accreditation cycles which resulted in the International Academy of Emergency Dispatch (IAED) recognizing the center as a mentor for other dispatch agencies interested in seeking accreditation. What’s unique and universally appreciated about Adam is that he approaches all tasks no matter how big or small, with the same vigor and enthusiasm. Adam is trusted to represent REMSA on the Washoe County Health District/District Board of Health, the region’s EMS Oversight Committee, and the Truckee Meadows Fire Protection District Board. Adam is well respected among his peers in the community and actively builds relationships with community stakeholders and public safety officials.

“Many of the relationships we (REMSA) have with our healthcare partners, co-responding agencies, and community leaders today are a direct result of the framework that Adam has put in place.” – Jason Hatfield, NRP, Clinical Coordinator, hiREMSA

Adam simultaneously displays a seriousness that conveys the importance of EMS work and a playfulness that eases the often heavy tone of EMS work. Adam continues to work patch-to-patch with ground field providers and dispatchers during regular shifts, special events, and when the system needs additional support. Adam is a mentor to staff all throughout the organization and regularly shares complimentary emails highlighting a job well done.

“You can find Adam grabbing a headset to help out in the communications center as well as jumping on an ambulance to run calls which provides an opportunity to engage in the front-line staff experience.” – Sarah Vonarx, Applications Administrator/AEMD, REMSA

Over the last two and a half years, Adam has made a commitment to working closely with the public affairs department to raise awareness about EMS, safety, health, and wellness. Adam now serves as REMSA’s primary on-camera media spokesperson, at-the-ready to assist with interviews on topics that range from flu shots and heat exhaustion to reimbursement, system status management, and the misuse of 911. Adam is a tremendous asset to REMSA as it positions itself as a high-performance, high-value EMS system and the regional mobile health care expert.

Adam has received two official recognitions for outstanding service throughout his career. In 2012 Adam was honored with an Achievement Award in response to the Reno Air Races tragedy which killed 11 people and injured 69 more during a spectator special event. In 2013, Adam was given the Meritorious Award for successfully resuscitating a young fan that suffered cardiac arrest at a University of Nevada Reno sporting event.

Adam is particularly enthusiastic about enhancing the different professions across the EMS and mobile healthcare industry. Adam conceptualized and launched a standardized uniform, badge, and collar brass look for all leadership levels at REMSA. In addition, Adam advocates for accountability across all provider levels and encourages all employees to represent REMSA’s brand proudly and with integrity. Finally, Adam believes that prehospital care and the profession of Paramedicine should be standardized and recognized at the university level.

Adam’s energy, high ethical standards, and intellect inspire people around him to do their best.

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View all of the 2020 Mobile Healthcare 40 Under 40 Honorees

January Law Changes– OR, NJ, NY, NV

Oregon Pregnancy Accommodations Law

 

Following many other states, the new law prohibits employers from deny employment opportunities to applicants or employees who need reasonable accommodations due to or related to their pregnancy or childbirth. 

New Jersey Pay Inquiry Restrictions

 

This law prohibits screening candidates based upon an applicant’s prior wage history. It is also illegal to establish a job candidate’s salary or benefits compensation based upon their prior salary or wage history.

New York Pay Inquiry Restrictions

 

This law prohibits all employers from inquiring about a job candidate’s wage history or relying on prior wage levels in establishing compensation or benefits.

Nevada Pre-Employment Marijuana Testing Restrictions

 

This law exempts employees who are firefighters, EMTs or who operate motor vehicles during the course of their duties.  While this would eliminate many positions within an EMS agency.  EMS employers who are not Federal Contractors or Grantees, need to heed these restrictions for those positions within their organization that do not fit into one of the exempt positions below.

In Memory of Patrick Wells Smith

Patrick Wells Smith, age 65, passed away unexpectedly on June 21, 2019, at his home in Reno, Nev.  He was well-known as a nationally-respected innovator and icon in the Emergency Medical Services (EMS) industry. Most recently he was the President and CEO of REMSA (Regional Emergency Medical Services Authority) and Care Flight, based in Reno, from January 1990 through March 2013 and then President of SEMSA (Sierra Emergency Medical Services Authority) also based in Reno,  from April 2013 to June 2018.

He was born on November 17, 1953 in Minneapolis, Minnesota, to parents Ted Arvel Smith and Margaret Wells Smith. He was the second of three children. He attended Minnetonka High School, got his start as an EMT in 1973 as a college student in Minnesota, and soon began taking on supervisory roles for EMS agencies in Minnesota and Oregon. In 1980 he was hired as an assistant director of Metropolitan Ambulance Services Trust in Kansas City where he consulted to establish EMS systems in Fort Wayne, IN.; Pinellas County, FL; Fort Worth, TX; and Little Rock, AK. He worked as Vice President of Eastern Ambulance in Syracuse New York after that before moving to Reno. 

He was well known for his innovation and leadership in EMS systems design and medical 911 communications systems. One of his most fascinating stories was his role as a first responder at the 1981 collapse of the walkway at the Hyatt Regency in Kansas City where he was one of the initial responders on site. It killed 114 people and injured 216. That experience inspired the ways he help REMSA to prepare for many crises in which the team needed to respond with speed and outstanding systems, but still compassion.

During his time at REMSA he created and fostered programs such as the special events coverage team, community and professional education teams, and the TEMS program which attaches specially-trained paramedics from REMSA to the SWAT teams of local law enforcement. He received numerous local and national awards, including the Secretary of Defense Employer Support Freedom Award for small businesses in 2008 where he was awarded the opportunity to meet the President of the United States.

He was proudest in his professional life when talking about his REMSA/Care Flight team. “It’s about the people,” he would often say. He was a proud and loving father and grandfather who passed on his devotion to Disney and instilled a deep loyalty to the Minnesota Vikings in his family. 

He was very active at the leadership level volunteering in the American Ambulance Association, and also NAPUM, National Association of Public Utility Model, which was a group of EMS organizations across the nation, each with the unique structure of a Public Utility Model, which provided guaranteed quality of care, response times and coverage without tax subsidies. REMSA had been one of those PUMs since its creation in 1986.

He is survived by his five children: Michelle Bergren (Matt), Aaron Smith (Divya), Danielle Sanford (Michael), Theodore Smith (Hailey), and Allison Hahn (Mark), his seven grandchildren: Blake, Sage, Bode, Rishi, Rohan, Hadley, and Cole, his nephews Jason  and Jeremy Smith, and the mother of his children and ex-wife, Linda Smith, who remained his good friend and co-parent/grandparent, as well as his many other friends and EMS and medical profession colleagues.

He was preceded in death by his parents, his sister Diana Smith and his brother James Smith. 

A celebration of life will be held on Tuesday July 2, from 4 to 7pm at 10379 Dixon Lane in Reno. 

In lieu of flowers, the family requests donations to Truckee Meadows Community College to the Patrick Smith Memorial Scholarship, which will be for students who want to study to become an Emergency Medical Technician, or a Paramedic. 

Please send donations to:

TMCC Foundation
7000 Dandini Blvd, RDMT 200
Reno, Nevada 89512-3999 

You can also donate online at: https://www.tmcc.edu/foundation/support-tmcc/make-gift. In the “Leave a Comment” box just note your donation is for the Patrick Smith Memorial Scholarship.

Nevada Passes Law that Restricts Employer Drug Test Use in Hiring

A new Nevada law that bans employers from refusing to hire job candidates who fail a drug test due to the presence of marijuana has specifically carved out Fire, EMS, or employers whose employees must operate a motor vehicle.  The new law, which was signed by Governor Sisolak on June 5th makes it unlawful for most employers to fail to hire a job candidate on the basis of failing a drug screen due to the presence of marijuana.  Nevada is the first state to pass a law of this nature.  The new law takes effect in 2020.

Many employers are struggling to address their employee’s drug use and its impact on the workplace as thirty-three (33) states and the District of Columbia have passed laws that legalize marijuana in some form.  This is particularly difficult with EMS and public safety employers.  Generally, most EMS and public safety employers prohibit employee use of marijuana and other drugs because they are federal contractors and are subject to the Drug Free Workplace Act.  Other employers prohibit employee drug use because EMS personnel perform “safety sensitive” positions as defined under the Department of Transportation Regulations.  However, those employers who are not subject to the Drug Free Workplace Act must be sensitive to this law for those employees that do not perform safety sensitive functions.  Employees in those non-safety sensitive positions, such as administrative duties, may be protected by laws like the law that was just passed in Nevada.

It is critical that employers understand their rights and responsibilities as it applies to drug testing and workplace drug use.  The American Ambulance Association can assist member companies who are struggling to make sense of this new law and what they can do to control drug use in their workplace. The AAA held numerous EMS Supervisor SimLabs last year which put EMS Supervisors and Managers through the paces of conducting an investigation of a Sexual Harassment allegation.  We are excited to announce that we are adding to the SimLab offerings with a new workshop specifically geared for Workplace Drug Use & Reasonable Suspicion in EMS.  To learn more about this, or any EMS Supervisor SimLab, please contact the AAA.

Status of the American Health Care Act

Today, citing “growing pains” of his Republican majority, Speaker Paul Ryan (R-WI), in consultation with President Donald Trump, determined not to proceed with a planned vote on the American Health Care Act (AHCA), which repealed and replaced important elements of the Affordable Care Act (ACA).  The Speaker indicated that the House Republican Caucus “came up short” in the number of votes needed for the bill.  House Republican Leadership had been moving AHCA through the Chamber at a rapid pace.  The bill was officially released on March 6, and had been changed several times to try to appease various conservative and moderate voting blocs within the Republican Caucus.  The Congressional Budget Office (CBO) originally estimated the bill would reduce federal deficits by $337 billion, and subsequently downgraded the deficit reduction to $150 billion based on additional substantive policy changes to the bill.  The CBO estimates the bill would have increased the country’s number of uninsured by about 24 million people.

In negotiating the provisions of AHCA, the House Republican Leadership had faced a constant seesaw, as efforts to appease one ideological bloc upset the other.  Ultimately, throughout the day in advance of the scheduled vote, an increasing number of moderate Republicans, including Appropriations Committee Chairman Rodney Frelinghuysen (R-NJ), announced they would vote against the bill.  As the moderates disappeared, not enough members of the conservative Freedom Caucus decided to support the bill.

As disarray in the House Republican Caucus occurred, there appeared to be a similar lack of consensus amongst their Republican colleagues on the Senate side.  While Senate Leadership had planned to move the bill directly to the Senate floor as fast as within a week of receipt from the House, there were a number of Senators from a range of political perspectives with serious concerns about the bill.  On one side of the Republican spectrum, Senators Rand Paul (KY), Mike Lee (UT) and Ted Cruz (TX) had planned to push the limits of what can be included in a reconciliation bill to make it more conservative. Senator Paul had advocated for repealing the ACA in full and dealing with the replacement later on. On the other side, more moderate or “purple state” Members like Senators Susan Collins (ME), Lisa Murkowski (AK), Rob Portman (OH), Cory Gardner (CO) and Dean Heller (NV) raised concerns about insurance affordability and the expedited rollback of Medicaid expansion in the House version of the bill. Other Senators who will likely play a prominent role in any further health reform developments include physician Senator Bill Cassidy (LA), and Senator Tom Cotton (AR), who advocated all along to slow the process down. Republicans can only lose two Senators and still pass any health reform bill, with the vote of Vice President Mike Pence breaking the tie.

As a next step, House and Senate Republican Leadership plan to take more time to develop consensus in any future approach to health reform.  How much time is unclear – but it seems unlikely the bill will be the legislative focus in the short term.  Instead, there will likely be a cooling-off period on health reform legislative activity, since the fundamental disagreements within the caucus are not easily fixed.  There will continue to be significant messaging against ACA from conservatives, and there is the potential that the idea of “repeal and delay” may gain more traction.  Nonetheless, in the short term, the Speaker indicated he would move on to other items on his conference’s agenda – including tax reform.  Keep in mind, however, that since health-related tax provisions are a major component of the tax code, it would not be surprising to see some health issues resurface in tax reform.

The Speaker indicated that he expects the ACA marketplace to get worse – specifically citing rising premium costs.  In his own remarks on the failure to pass AHCA, the President suggested the Democrats will own any rising premiums, and provided a rare moment of optimism for the day when he indicated that a bipartisan health care reform bill may be achievable in the future when that happens.   As the Legislative Branch takes time to develop consensus, more focus will be placed on the Executive Branch.

We expect HHS Secretary Tom Price and White House Budget Director Mick Mulvaney to take an increasingly important role in driving the health agenda.  It is unclear at this point whether the Trump Administration will let ACA drift in the wind, take administrative actions to try to improve the marketplace, or even actively work to derail it further.  A likely bellwether as to the Administration’s intent is how it approaches the pending litigation over cost-sharing reduction (CSR) subsidies.  The House had sued the Obama Administration over the program, which funnels federal dollars to insurers to help keep out-of-pocket costs manageable for lower-income individuals, saying the funding had to be appropriated.  But after the inauguration, the House and Trump Administration sought a stay of the case until May 22 to allow time to resolve the issue.  If the Administration agrees to fold, the subsidies would be cut off, leading to further market instability.  If the House folds, the CSR payments would continue into the indefinite future.

From a health care legislative perspective, 2017 will still be far from a quiet year.  The President has proposed significant changes in the funding levels of important discretionary health programs.  Those budget battles will now move more front and center on the legislative agenda.  Furthermore, there continue to be “must pass” pieces of health care legislation, including CHIP reauthorization, FDA User Fee legislation, and certain Medicare extenders legislation.

ACA Repeal & Reform – What It Means for Ambulance Services

By: Tristan North and Kathy Lester, JD, MPH

This is the first of a two part Member Advisory by Tristan North and Kathy Lester on ACA Repeal & Reform. To continue reading, see Part Two: ACA Repeal & Reform – What It Means for Ambulance Services (Pt. 2).

Overview

A top priority of President Trump and congressional Republicans is to repeal and replace the Affordable Care Act (ACA). Since Republicans retook control of Congress in 2012 after passage of the ACA in 2010, they have sought to repeal the ACA. However, they had not developed a consensus on a replacement package, as they knew then-President Obama would veto the repeal bill. Now with President Trump in the White House and Republicans controlling the House and Senate, Republicans in the House have agreed upon a package and moved it through three Committees of jurisdiction: the Ways and Means Committee, the Energy and Commerce Committee, and the Budget Committee. Republicans in the Senate are less aligned and are said to be working on their own package, which is likely to differ in important ways from the House version.
For ambulance services, there are several key components to watch. These are:

  • Coverage for ambulance services. Expressed in terms of providing more flexibility, there is concern that some insurers are pushing and some Republicans agree that the concept of a minimum set of covered services (essential health benefits (EHB)) should be narrowed or even eliminated. Currently, only emergency services are included as an EHB, but through the designation of benchmark plans, non-emergency services have also been covered. If the benchmark plans requirements are modified, coverage for non-emergency services could become an issue.
  • Medicaid expansion. The Administration has sent a clear signal that it plans to roll back the expansion of Medicaid, which provide coverage to many Americans who had signed up under the ACA. For ambulance services in expansion States, the elimination of this program could result in more uncompensated care problems.
  • Coverage more generally. Republicans have clearly indicated a desire to eliminate the individual mandate. This could have two effects that may impact ambulance services. First, if people are not required to have coverage there are many who will not have it. It is not certain whether without coverage these individuals will be able to pay for the services they receive, which could lead to more uncompensated care. Second, individuals who do not purchase health insurance often are younger and healthier. Without such individuals in the risk pool, it is possible that premiums and other cost-sharing requirements will increase making it more likely for sicker individuals who cannot afford care becoming uninsured.
  • Employer costs and obligations. The House Republican legislation includes several provisions that relax the obligations and/or provide tax relief to employers providing health insurance. Such provisions could be beneficial to ambulance services in terms of providing health care coverage for their employees.

In addition, there are a few other provisions that the current bills being considered do not modify, but potential could be part of the discussions at some point or in subsequent Medicare legislation.  Of these, there are three that would directly impact ambulance services.

  • Productivity Adjustment. As part of the ACA, the annual inflation updates for the Medicare ambulance fee schedule rates are now subject to a productivity adjustment, which reduces the amount of the update. CMS subtracts a projection of the non-farm business multi-factor productivity adjustment (MFP) from the Consumer Price Index – Urban to determine the update amount.
  • Inflation Index Below Zero. Prior to the ACA, the Medicare inflation update for ambulance rates could not be a negative percentage. Under ACA policies, the update may be a negative percentage. For example, in 2011, the CPI-U was 1.1 percent and the productivity adjustment was 1.2 percent, which resulted in a cut to the rates of 0.1 percent. In 2016, the CPI-U was 0.1 percent and the productivity adjustment was 0.5 percent, which resulted in a cut of 0.4 percent. 
  • GPCI Increases. The ACA made a temporary change to the practice expense component of the physician geographical price cost index (GPCI), which is the entire GPCI for reimbursement under the Medicare ambulance fee schedule. The change established a minimum 1.0 GPCI for ambulance payments from January 1, 2010, to December 31, 2010. As a result of these changes, rates under the Medicare ambulance fee schedule for localities with a GPCI of less than 1.0 saw an additional temporary increase in reimbursement rates. Localities with a GPCI of 1.0 or higher were not be affected by the provision. The provision was retroactive to January 1, 2010 and the increases escalated for 2011 before expiring on December 31, 2011.

The ACA also established a permanent GPCI floor of 1.0 for “frontier” States which took effect in 2011. The designation of a “frontier” applies to those states in which 50 percent of the counties are frontier which have less than 6 people per square mile. The designation is updated with the original frontier states consisting of Montana, North Dakota, South Dakota, Utah and Wyoming. Utah is no longer deemed frontier and Nevada has been added to the list. While a complete repeal of the ACA would not impact the temporary GPCI increases as the provisions were temporary, it would eliminate frontier status.

Community Paramedicine’s Growth Hindered by Reimbursement Issues

From Politico’s “Reimbursement issues block paramedics from expanded role“—

Despite the track record of [community paramedicine] initiatives in places like Nevada and Texas, where paramedics are providing in-home care, coordinating patient services and saving millions in the process, Medicare, Medicaid and most private insurance plans still won’t reimburse for such work. The program successes to date are only beginning to change that…

Nationwide, the impact from reducing ambulance calls and demands on ERs while freeing up doctors could be huge. A 2013 study in Health Affairs estimated that more flexible reimbursement for paramedicine approaches could save Medicare $283 million to $560 million annually and similar sums for private insurers.

Kaiser Health News: REMSA Paramedics Steer Non-Emergency Patients Away From ERs

Innovation in Reno
REMSA program empowers EMS, helps patient outcomes, and cuts costs.

Yesterday Kaiser Health News reported that AAA member organization Regional Emergency Medical Services Authority (REMSA), is serving its community in innovative ways that reduce healthcare costs and improve patient outcomes. Initiatives led by REMSA CEO Jim Gubbels empower Reno paramedics to lower the number of preventable emergency room visits and close gaps in primary health care.

Using a $9.8 million federal grant, [REMSA CEO Jim Gubbels’] agency launched three different projects. In addition to providing paramedic home visits and offering patients options besides the ER, the agency started a nurse-run health line to give people with health questions another number to call in non-emergency situations.

An early evaluation by the University of Nevada, Reno, which was based on insurance claims and hospital data, shows that the projects saved $5.5 million in 2013 and 2014. They helped avoid 3,483 emergency department visits, 674 ambulance transports and 59 hospital re-admissions, according to the preliminary data. The federal government plans to do its own evaluation.

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