CMS launches new payment model for emergency care: 5 things to know

CMS has selected 205 participants for its new, five-year Emergency Triage, Treat and Transport Model.

Five things to know:

1. The CMS innovation center unveiled the ET3 model in February 2019. The new model aims to give ambulance care teams more flexibility in how they triage emergencies.

2. Medicare currently pays for emergency ambulance services when beneficiaries are transported to hospitals, skilled nursing facilities and dialysis centers. Most beneficiaries who call 911 with a medical emergency are taken to a hospital emergency department. Under the ET3 model, Medicare will reimburse for transport to an urgent care clinic or primary care office, or for providing care in place or using telehealth.

3. The goal of the five-year payment model is to improve care quality and cut costs by reducing unnecessary hospital visits for low-acuity emergencies that do not require a trip to the hospital.

4. CMS said it is notifying ambulance providers that have been selected for the ET3 model to give them "ample time to establish the partnerships needed" with local urgent care centers, physicians and telehealth providers. The new payment model is slated to begin this spring.

5. Another component of the ET3 model involves state and local governments, or those they designate to receive 911 calls, to establish medical triage lines in regions where ambulance providers are participating in the new model. CMS said it plans to issue a notice of funding opportunity for up to 40 agreements that would last two years.


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