Source Article | Comments courtesy of Matt Zavadsky

A very logical step being taken by the Pennsylvania legislature! 

And, one that is currently in place for payers such as Anthem and the Medicaid programs in Arizona and Georgia.  Additional payers are looking to implement similar programs.

Decoupling payment from transport helps enhance patient outcomes, improve the patient’s experience of care, and significantly reduce the down-stream cost of care. 

The misalignment of incentives of only reimbursing ambulance TRANSPORT to an ED is a significant cost driver.  In 2013, Health Affairs published a RAND study that determined that 12.9 – 16.2% of Medicare ambulance trips to the ED could have safely and effectively been managed in an alternate setting, and giving EMS flexibility to navigate patients could save the Medicare program up to $560 million annually.

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Barrar's bill to reimburse ambulance companies heads to governor

Digital First Media Oct 23, 2018

WEST CHESTER—Legislation drafted by state Rep. Steve Barrar, R-160, that would require ambulance companies to be reimbursed for providing medical treatment, even if the patient is not transported to a hospital, was successfully voted on concurrence by the House.

“The critical services provided by ambulance companies to Commonwealth citizens in their time of need will remain endangered, potentially to the point of extinction, if they aren’t reimbursed for their costs to render emergency care. My bill would entitle ambulance companies to payment when emergency medical responders treat and stabilize patients without a trip to the hospital,” Barrar said.

Under current practice, EMS agencies can only be reimbursed by insurance companies if they transport the patient, even though time is spent, supplies are used and services are provided regardless of whether a transport takes place. This is a significant contributor to the financial challenges facing ambulance companies, especially when many are facing the grim reality of pending closures.

House Bill 1013 would require reimbursement when transport to a facility does not take place as long as the following conditions are met: The Basic Life Support (BLS) or Advanced Life Support (ALS) unit must be dispatched by a county 911 center, and the EMS provider must have rendered emergency services even though the transport was declined.

Also, the House approved legislation to close a loophole that PennDOT has been using to deny free emergency vehicle license plates to volunteer fire companies that also have paid employees.

“Volunteer ambulance services all across the Commonwealth have been forced to pay for a plate that should have been given to them at no cost. It’s disappointing that PennDOT would take advantage of volunteer companies that save Pennsylvania so much money, but I’m pleased that I was able to influence the addition of an amendment on the bill to address this issue,” Barrar added.

Both bills now advance to Gov. Tom Wolf for consideration.