It’s been a week full of announcements from the Department of Health and Human Services. After proposing interoperability rules earlier this week, it now has news about a payment model surrounding emergency medical transportation for Medicare beneficiaries.
On Thursday, CMS launched the Emergency Triage, Treat and Transport (ET3) model. Through it, the agency will continue to pay for Medicare beneficiaries’ emergency transport to a hospital ED or other destination covered under current regulations. Additionally, CMS will pay ambulance suppliers and providers to:
Behavioral Health, Interoperability and eConsent: Meeting the Demands of CMS Final Rule Compliance
In a webinar on April 16 at 1pm ET, Aneesh Chopra will moderate a discussion with executives from DocuSign, Velatura, and behavioral health providers on eConsent, health information exchange and compliance with the CMS Final Rule on interoperability.
- Transport a patient to an alternate location, like a primary care provider’s office or urgent care clinic
- Provide treatment in place with a practitioner, either on the scene or using telehealth
As of right now, Medicare only pays for unscheduled, emergency ground ambulance services when patients are taken to hospitals, critical access hospitals, skilled nursing facilities and dialysis centers. Many beneficiaries who call 911 are transported to one of these locations even when a lower-acuity destination would work. The ET3 model seeks to reduce avoidable hospital transports and unnecessary hospitalizations.
In a statement, HHS Secretary Alex Azar commented:
This model will create a new set of incentives for emergency transport and care, ensuring patients get convenient, appropriate treatment in whatever setting makes sense for them. Today’s announcement shows that we can radically rethink the incentives around care delivery even in one of the trickiest parts of our system. A value-based healthcare system will help deliver each patient the right care, at the right price, in the right setting, from the right provider.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
The ET3 model is voluntary and will have a five-year performance period. The anticipated start date is January 1, 2020, and the anticipated performance period end date is December 31, 2024.
The Center for Medicare and Medicaid Innovation intends to release a request for applications this summer to solicit Medicare-enrolled ambulance suppliers and providers.
Photo: utah778, Getty Images
