Tag: payment reform

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…

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Fighting for the Future of Ambulance Organizations

AAA Executive Vice President, Maria Bianchi, recently penned an Op-Ed for JEMS entitled: Join AAA in Fighting for the Future of Ambulance Organizations. Learn about the AAA’s work towards Payment Reform and join us in our fight for our future. Help ambulance organizations be identified as healthcare providers by those who have influence on our regulations and reimbursement rates.

Learn more about 2017 AAA Member Benefits!

Ambulance Payment Reform Whiteboard Video

The American Ambulance Association needs your help to build the future of EMS—an innovative industry compensated fairly and recognized appropriately for the critical healthcare it provides. Learn more in the video below, then visit our Payment Reform page to get involved!

Ambulance services across the country are struggling to survive in the face of falling reimbursement, short-sighted regulations, and rising costs. EMS providers of all sizes must share critical cost data, meet with legislators, and speak with one voice as we work to surmount these obstacles and position ambulance services for success today and for many years to come.

EMS Today: Payment Reform Town Hall

EMS Today Conference & Exposition
Maximize your time at EMS TODAY by adding half-day or full day pre & post-conference workshops to your Gold (3-day) or Silver (2-day) full conference registration.
These unique, CE certified workshops are designed to provide in-depth clinical and hands-on instruction to students and will take place on Wednesday, February 22, 2017. These workshops are taught by recognized experts in the world of EMS.
ADD 1 or 2 today! Don’t forget that complimentary lunch is provided for all attendees registered for two onsite 4-hour workshops or one 8-hour workshop!
FEATURED WORKSHOP
American Ambulance Association’s Town Hall Meeting on Payment Reform (#16200)
Wednesday, February 22, 2017: 1:00 PM – 5:00 PM
Workshop Description
The AAA has been leading efforts on Capitol Hill to take the initial steps necessary to reform the Medicare ambulance fee schedule. It began with the successful securement and multiple extensions of the 2% urban, 3% rural and super rural increases in Medicare payments for ambulance services. Through the Medicare Ambulance Access, Fraud Prevention and Reform Act (S. 377/H.R. 745), those increases would be made permanent and set the foundation for future reform by changing the status of ambulance service suppliers to that of providers, collecting data on the cost of providing ambulance services and addressing fraud and abuse with dialysis transports. EMS needs to be considered providers and have cost data if we are to make data driven changes to the fee schedule beyond ambulance services just being a transportation benefit. The AAA Payment Reform Committee is looking at what Medicare reimbursement policy would look like as providers of health care services with the data to support changes in ambulance policy. The Committee, comprised of representatives of the AAA, NAEMSP, NAEMT and NASEMSO, has developed a policy payment outlining the future of reimbursement for EMS including treat and refer, mobile integrated health and alternate destinations. Come to this special Town Hall Meeting on Payment Reform to hear about the activities of the Committee in detail and provide valuable input for the future of ambulance reimbursement policies.

Speakers:
Jimmy Johnson
Owner & President, LifeEMS, Past President, American Ambulance Association, United States

Kathleen Lester
Principal, Lester Health Law PLLC, United States

Asbel Montes
V.P. of Governmental Relations and Reimbursement, Acadian Ambulance Service, United States

Tristan North
S.V.P. of Govt. Affairs, American Ambulance Association, United States

Cost:
Open to all registered EMS Today attendees. There is no charge to attend this workshop, but registration is required.

Register Today CLICK HERE to learn more about the
Pre & Post-Conference Workshops
EMS Today Conference & Exposition

 

Payment Reform Chairs Pen Op-Ed in JEMS

Ambulance payment reform is critical to the future of emergency medical services across our country. Don’t miss the op-ed in JEMS by Asbel Montes and Jimmy Johnson, chair and vice chair of AAA’s Payment Reform Committee.

Before the industry as a whole can embrace mobile integrated health, community paramedicine, and value-based purchasing, the industry must contend with standardizing cost data and submitting it to the federal government. We must also fight to ensure that payment is linked to the health care services provided and less to the act of transporting patients.

Read the full op-ed►

Ready to add your voice to the conversation? Join fellow members at AAA’s Payment Reform Town Hall at EMS Today in Salt Lake City. Learn more►

MetroWest’s JD Fuiten on Mobile Integrated Health

Metro West Ambulance’s Mobile Integrated Heath Program is a leader in the emerging world of community paramedicine and MIH.  The successes in our programs have been centered on the strong relationships we have built with our health system partners.  This partnership allows Metro West Ambulance MIH paramedics to better participate in the longitudinal care of our patients instead of the focused, episodic care of traditional EMS. We have now positioned ourselves as an integral part of the health care team.  The value of an MIH paramedic continues to expand as the skills, tools and knowledge of the paramedic profession as a whole continues to increase.

As the success of the MIH programs across the country continue to prove their value, we look forward to full recognition by CMS as a valuable patient care service that should be recognized outside of the traditional transport fee for service.

JD Fuiten
CEO, Metro West Ambulance
Director, AAA Board
2015 AAA Distinguished Service Award Winner
Hillsboro, OR

Telling Our Story

To this day, ambulance services in the United States are still the only health care provider that delivers care regardless of a patient’s ability to pay. When you call 911, the medics show up and immediately begin providing health care. No one asks for an insurance card, or a credit card. They ask questions regarding the patient’s medical history… anything they need to know to provide better patient care.

Ambulance services provide more uncompensated care than any other health care professional in the United States. They must be ready to provide that service any moment, any hour of any day. There are no “office hours” or closed signs.

For many patients and their families, they are the best things to happen on the worst day of their lives. They take care of us.

But for whatever reason, some legislators, regulators, insurers look at our providers as transportation services, a commodity, and a supplier of services like durable medical equipment. They assume our costs are related to each trip and rarely consider that we always have to be ready to respond and only get paid when we transport. That is until someone they love needs us.

The AAA leadership is committed to changing all that. We refuse to let our industry be defined by stakeholders who may not understand the complexities of our world, of our medicine, our protocols and our services. We are looking to change the course of our future by mandating that we be viewed as providers and not suppliers or widgets. We fervently and wholeheartedly believe that we make an even greater difference to the health and well being of the communities we serve because of our distinct nature of our services: we are mobile, we are everywhere, we are underutilized because of a reimbursement structure that only allows for compensation when transporting. Therefore, the only way for ambulance services to not just survive but thrive in any future health care system is to attain provider status. It is the game changer. It puts us in the drivers seat regarding the type of service we should provide (treat and refer, alternative destinations, collaborative models of care). It makes our services more nimble, efficient, and better able to serve our communities.

Because CMS will mandate cost reporting for anyone getting reimbursement through their programs, we are fighting hard to insure that our data is collected accurately, allowing our industry of primarily small, rural providers who at times are the only ones within 100’s of square miles providing health care the least burdensome way of providing that data… and make no mistake, folks—we need data to prove what every ambulance service providers knows in the United States… we are significantly underpaid by Medicare and Medicaid. So I implore every ambulance service to join us in our fight for our future… to help us be identified by those who have influence on our regulations and reimbursement rates, that we have been and are providers of health care and as such need to be recognized and compensated for the lifesaving work we do.

We cannot do it without you.

Get Involved with AAA’s Advocacy Efforts

Maria Bianchi, CAE, is the executive vice president of the American Ambulance Association.

Cataldo Ambulance’s Ron Quaranto on Mobile Integrated Health

As a current mobile integrated health provider, we recognize the values of an MIH program which most importantly provides quality patient care to those in need, often in the comfort of their own homes. This is often done under the direction of the patient’s primary care physician in conjunction with the patient’s healthcare team. This allows for the patient to maintain their quality of life while receiving the medical attention they need—and ultimately reducing the healthcare expenses of hospitalization.

Ron Quaranto
COO, Cataldo Ambulance Service

Life EMS’s Jimmy Johnson on Sustainable Reimbursement

To address the importance of the work that the payment reform committee is doing, we must consider the value of the part that small providers play in the healthcare delivery system today, and how imperative it is that we accomplish goals such as moving from Supplier to Provider status for all ambulance services in order to set the table for reimbursement that is more creative than just fee for transports. For example, 73% of all ambulance services who are credentialed by Medicare do less than 1,000 transports per year, which does not add up to sustainability for ambulances services endeavoring to adhere to best practices in providing emergency medical care.   A vast majority of those services represented in the 73% are the first line—and in many cases the only line—of emergency medical care in their communities.

—Jimmy Johnson
CEO, Life EMS
Past President, American Ambulance Association
Co-Chair, American Ambulance Association Payment Reform Committee
Enid, OK

Regional Ambulance Service’s Jim Finger on AAA Advocacy

EMS serves all Americans—24 hours per day, 7 days per week, 365 days per year. This is especially important in rural communities like mine, where hospitals and clinics may not be accessible to some of our most vulnerable populations, including the elderly, disabled, and chronically ill.

The American Ambulance Association’s legislative effort to ensure that government cost reporting requirements do not overly burden these mostly small healthcare providers has bipartisan support from coast to coast. At present, it is cosponsored by 30 representatives from 18 states as well as nine senators from both sides of the aisle. The same piece of legislation, the Medicare Ambulance Access, Fraud Prevention and Reform Act (H.R. 745, S. 377), ensures permanent, sustainable reimbursement for ambulance services, allowing us to stay focused on the most important part of the job—caring for you and your family in your time of need.

Please consider encouraging your members of congress to support the AAA’s legislation. A vote for AAA’s bill is a vote for the future of EMS in America.

— James (Jim) Finger
CEO, Regional Ambulance Service
Past President, AAA Board of Directors
Rutland, VT

Acadian’s Asbel Montes on Ambulance Payment Reform

“EMS is instrumental to the healthcare fabric of our country. As the healthcare industry continues to innovate, it is imperative to recognize the value that EMS brings to the pre- and post-hospital environment. EMS providers are the only gatekeepers to the healthcare system in many communities.

73% of all ambulance suppliers credentialed with Medicare bill the program less than 1,000 transports per year. It is imperative that any cost data collection system reporting requirements consider this to ensure the reliability of the data and the administrative burden to ambulance providers and suppliers.”

Asbel Montes
Vice President of Governmental Relations & Reimbursement, Acadian Ambulance
Co-Chair, American Ambulance Association Payment Reform Committee