HHS launches payment model for ambulance providers: 5 things to know

HHS debuted a new payment model for emergency ambulance service providers.

Five things to know:

1. Medicare currently pays for emergency ambulance services when beneficiaries are triaged to an emergency department. HHS said this incentivizes ambulance providers to transport all beneficiaries to hospitals, even if a different site of care would be more appropriate.

2. Under the new Emergency Triage, Treat and Transport model, dubbed ET3, two new ambulance payments will be tested for Medicare fee-for-service beneficiaries. The first payment is for transportation to a healthcare practitioner, either in person at a clinic or through a telehealth visit. The second payment is for unscheduled emergency transport to a 24-hour clinic or similar destination.

3. The five-year ET3 model will begin in early 2020. In later years of the model, ambulance suppliers and providers will be eligible for 5 percent payment increases tied to quality measures.

4. CMS will open applications for the payment model to ambulance suppliers and providers this summer. The agency will issue a notice of funding opportunity for a limited number of two-year agreements to implement triage lines for low-acuity 911 calls. The agreements will be available for local governments, their designees or other entities with 911 dispatch authority.

5. CMS plans to call on ET3 participants to partner with other payers, including state Medicaid programs.

For more information on ET3, click here.

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