September 17th, 2016

If unnecessary hospital readmissions are, as some suggest, the low-hanging fruit in the pursuit of better healthcare, hospitals should get ready to pluck less and less.

Hospital administrators have had years—four since Medicare’s Hospital Readmissions Reduction Program took effect, and six since the Affordable Care Act spurred a slew of other initiatives to improve healthcare value—to scrutinize and cut down on unnecessary readmissions. And in those years, the U.S. has largely managed to do so, new numbers from the CMS show.

From 2010 to 2015, readmission rates among Medicare beneficiaries fell in Washington, D.C., and every state but one, the CMS reported. That drop translates to about 565,000 avoided readmissions for Medicare beneficiaries since 2010, including 100,000 in 2015 alone.

That momentum could soon slow. That’s not necessarily a bad sign, because not all readmissions are preventable. But it also means hospitals and other providers will have to work smarter to keep making progress on readmissions.

A bevy of CMS initiatives have taken aim at improving healthcare quality while holding down or even trimming costs, with the ambition of tying 90% of traditional Medicare payments to quality or value by 2018. Unnecessary hospital readmissions, regarded as an indicator of poor quality care, play a burgeoning role.

The idea that hospitals can avoid readmissions by providing better follow-up care once patients are discharged is at the heart of the Hospital Readmissions Reduction Program. Under it, those that fail to curb excess readmissions lose out on a portion of their Medicare reimbursements.

The program took effect Oct. 1, 2012, and has imposed increasingly hefty financial penalties on hospitals whose avoidable 30-day readmission rates for a limited list of conditions exceed the national average. For fiscal 2017, which starts Oct. 1, the CMS will penalize more than 2,500 hospitals, saving the agency about $538 million.

Readmissions targeted by the Medicare program are for a narrower set of conditions than the 30-day all-condition hospital readmission rates published by the CMS last week, but the CMS said the program was one factor in reducing avoidable readmissions.

But some providers and policy experts are concerned that imposing financial penalties to drive down excess readmissions could move hospitals to take measures that go too far.

“I think we’re going to reach a point of diminishing return, where to reduce readmissions further is eventually going to be perceived as underdelivering care and almost being cruel,” said Dr. Martha Radford, chief quality officer at NYU Langone Medical Center in New York. “Not all readmissions are preventable, and it’s kind of tough to know which ones are and which ones aren’t, particularly in advance.”

Hospitals can still do more to reduce the unnecessary ones, said Dr. Eric Coleman, a professor at the University of Colorado, where he also heads the healthcare policy and research division. “But the relative return on investment going forward will be less,” Coleman said.

Medicare views hospital readmission rates as an important indicator of the quality of care because they reflect the breadth and depth of care a patient receives. If hospitals fail to treat a patient fully or ensure that the patient has a feasible discharge plan, that patient could end up coming back to the hospital for care. Unnecessary readmissions are also expensive, costing the U.S. $25 billion annually, by one estimate.

More tightly coordinated care and better communication between hospitals and post-acute providers have indeed helped hospitals prevent readmissions and improve the quality of patient care, Coleman said.

“This is a fairly dynamic process, where we believe that what we’re doing is reducing modifiable risk,” Coleman said. But, he warned, “There certainly are people whose risk may not be so modifiable. They really do need to be readmitted. We don’t want to deny care on that end.”

One unintended consequence of Medicare’s focus on readmissions, according to some critics, is that hospitals are keeping patients in outpatient observation status rather than admitting them.

“It has been the case that the hospitals have been gaming the system in extraordinary ways,” said Ross Koppel, a sociology professor at the University of Pennsylvania who conducts healthcare research.

A Wall Street Journal analysis of Medicare billing data late last year concluded that hospitals were indeed gaming the system by classifying patients as being on observation status. Two months later, HHS researchers countered in the New England Journal of Medicine that the small increase in observation claims couldn’t explain a more substantial drop in readmissions.

Providers and their advocates argue that it’s often better for patients to be held for observation rather than admitted. “Observation status helps ensure that the most appropriate setting of care is where the patient ultimately receives their care,” said Lorraine Ryan, senior vice president of legal, regulatory and professional affairs at the Greater New York Hospital Association. It gives a provider more time to evaluate patients before deciding if they should be formally admitted.

And other challenges remain. Despite the progress by hospitals and post-acute care providers, the quality of care that patients receive after they’re discharged still leaves much to be desired. Improving it will require grappling with thorny issues such as insurance coverage and weak healthcare infrastructure in many parts of the U.S.

The reasons for gaps in care as patient’s transition out of the hospital and back home vary from the financial and logistical to the socio-demographic.

Some hospitals, especially safety net providers, care for disproportionate numbers of lower-income patients who live in communities without other healthcare services and resources essential for follow-up care, such as primary-care physicians and pharmacies. As a result, no matter what the hospital does, some patients might not be able to get the follow-up care they need.

“The strategies that hospitals are using, a lot of them are some of the same,” said Akin Demehin, director of policy for the American Hospital Association. “But certainly the challenges that they may face in their own patient population, in their own communities, in their own space, could look a little bit different.”

In other cases, patients or families are given instructions for care after discharge. But that doesn’t mean they can, or will, follow them.

“A lot of folks go home and just feel unprepared and start to panic,” Coleman said. Preventing avoidable readmissions “really is about preparing patients and families to be able to feel confident in their own self-care.”

And sometimes, a patient’s insurance will not cover the post-acute care services he or she needs, or will pay for only a portion.

“We’ve tried a lot of things—we make sure people have a follow-up appointment, we do arrange for visiting nurses, we’ll place them in some sort of chronic-care facility if possible. Often, it’s not,” said Radford, of NYU Langone. “The payment models don’t help here. Some people don’t have coverage for that type of thing.”

Of the 49 states where readmissions fell from 2010 to 2015, 43 saw decreases of more than 5%, and rates fell by more than 10% in 11 states. The one state where Medicare’s 30-day, all-condition hospital readmission rate rose was Vermont—from 15.3% in 2010 to 15.4% in 2015, which the CMS described as “virtually unchanged.”

And according to hospital leaders there, the state may be seeing what others throughout the country are about to experience: doing well on readmissions means lower rates of improvement.

“While Vermont’s readmission rates may not have changed drastically, they remain lower than in more than half of other states,” said Jeffrey Tieman, CEO of the Vermont Association of Hospitals and Health Systems. The state’s rate in 2010 was 1.3 percentage points below the median, according to CMS data.

“Our hospitals recognize that it can be hard to make progress on these types of measures when your state is already a strong performer,” Tieman said. “But they are focused on continuing to reduce readmissions even further by improving the way we coordinate and integrate care.”

Original article can be accessed here.

Cathy Hostettler is a Doctor of Nursing Practice candidate at the University of Kansas.

She did her Doctoral Thesis on EMS-Based MIH programs and their impact on readmissions.  She came to MedStar and did an analysis of our MIH programs and data, specifically as it relates to readmission prevention.

She has presented this paper to the doctoral review panel at the University of Kansas as partial fulfillment of her Doctor of Nursing Practice degree and has given us permission to share it widely …

Cathy did a nice job on this paper and it contains great published references about MIH-CP type programs in the U.S. and abroad…

Univ of Kansas Report on MedStar’s MIH Program Impact on Readmissions

Citation for use:

Hostettler, C. (2016). Mobile integrated healthcare: A program to reduce readmissions for heart failure (Doctoral project). University of Kansas, Lawrence, KS.

Reno, Nev.—Renown Health and the Regional Emergency Medical Services Authority (REMSA) have announced an innovative new alliance to improve the overall health of the region through a proactive system of healthcare services focused on doing the most good for the most people at the least amount of cost.

These Community Health Programs deliver healthcare services and focus primarily on reducing out of pocket costs and unnecessary use of the healthcare system while strengthening the quality and coordination of care and expanding access to the right level of care.

At the center of this alliance are three leading-edge programs: the Nurse Health Line, Community Paramedicine and the Ambulance Transport Alternative. The three programs comprise the REMSA Community Health Programs and were launched in 2012 through a three-year, $9.8 million Centers for Medicare and Medicaid Services Healthcare Innovation Award. Preliminary outcomes from the Community Health Programs show that they continue to facilitate healthcare access and reduce costs with more than 6,200 emergency room visits avoided, over 1,000 ambulance transports avoided and more than $9.6 million in savings to patients and the healthcare system.

After receiving an extension for a fourth year under the current funding amount, the program’s grant funding concluded this past summer. Going forward, thanks to this new alliance, the three programs will be financially supported by Renown. This is an unprecedented partnership based on a commitment from Renown, the region’s largest integrated health network, to REMSA, the region’s largest integrated emergency medical services provider.

REMSA predicts that continuing these innovative programs will have an economic impact of $1.6 million over the next year through savings to the community. By minimizing and avoiding costly ways of accessing healthcare such as unnecessary emergency room visits, hospital admissions, hospital readmissions and ambulance transports, there is more opportunity to provide proactive and necessary healthcare.

“These programs are vital to creating healthy communities by giving people access to services they might otherwise not know how to access,” said Dean Dow, president and CEO of REMSA. “Renown’s commitment to this partnership allows all three programs to continue and for the Nurse Health Line to be available to all citizens in the region.”

The formation of this relationship ensures that these pioneering programs will transition from being shorter-term, grant-funded innovations to comprehensive and lasting systems built to optimize the health of many people in the region. With the aligned goal of promoting health by expanding access to the right level of healthcare at the right time, these programs reinforce Renown’s and REMSA’s work to improve the overall health of the community.

Improving health across the region by strategically and proactively managing clinical and financial opportunities is a key outcome of partnerships like this. Population health management delivers care in a proactive system focused on making care better, more efficient and more cost-effective.  The Community Health Programs are an example of how delivering care that is managed and measured at the population level can lead to longevity, quality of life, and an increase in delivering care in to populations that need it most, thereby improving the health of people with undermanaged conditions and shifting the focus to prevention and wellness efforts.

“Renown is committed to improving the health of the community, which means more than just providing quality healthcare,” said Anthony D. Slonim, MD, DrPH, president and CEO of Renown Health. “It means going outside the hospital walls, offering programs and services that make a lasting difference in the health and well-being of families throughout our region. This can only be accomplished through collaboration with partners who share the vision of a healthier northern Nevada – partners like REMSA.”

REMSA is successfully achieving long-term financial sustainability for these programs through partnerships like this. REMSA is working with a growing number of partners and insurers to develop ongoing support for these new services.

“The emerging data indicates these programs are having a significant positive effect on the health of the community, especially in underserved neighborhoods,” said Kitty Jung, Chair, Washoe County District Board of Health and Chair, Washoe County Commission. “The Washoe County Health District applauds Renown and REMSA for creating this strategic partnership addressing the healthcare needs of our region.”

Since the Community Health Programs launched in 2012, a variety of community partners contributed to their success including hospitals, clinics, fire services, EMS oversight entities, urgent cares, health centers, and non-profit and community groups.

About REMSA

REMSA is a private, locally governed, non-profit emergency medical services provider serving northern Nevada since 1986. REMSA also comprises Care Flight, a regional, non-profit, air and ground critical care transport service, a Nevada-licensed, post-secondary educational institution, a state-of-the-art, fully accredited 9-1-1 dispatch communications center, a Tactical Emergency Medical Support team and community and special events EMS teams. REMSA provides quality patient care with no taxpayer support or other subsidies. For more information, visit remsahealth.com.

About Renown Health

Renown Health is a locally governed and locally owned, not-for-profit integrated healthcare network serving a 17-county region comprised of northern Nevada, Lake Tahoe and northeast California. Renown is one of the region’s largest private employers with a workforce of more than 6,000. It comprises three acute care hospitals, a rehabilitation hospital, skilled nursing, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition of being the first in the region to successfully perform leading-edge medical procedures. For more information, visit renown.org.

Original article can be accessed here.

States are increasingly turning to community paramedicine to help fill the gap in the health care workforce. States have been experimenting with community paramedicine programs for the last five years or more. Expanding the role of licensed or certified emergency medical technicians—or EMTs—and paramedics to provide non-emergency preventive health care services directly to patients in their communities can be cost-effective and make up for health care work force shortages.

Nevada Assemblyman James Oscarson said he was motivated to sponsor a community paramedicine law in 2015 because of the number of runs made by ambulances to pick up individuals who didn’t need to go to emergency rooms or be admitted to the hospital. Oscarson is a nurse and currently works as director of community relations at his hometown hospital.

In many rural areas of Nevada, doctors and nurses are in too short supply to provide the primary care services community residents need to stay healthy. But with the help of paramedics, according to Oscarson, patients with chronic diseases and other health needs may be better able to access the services required to manage their diseases, and prevent complications and admissions to the emergency room or hospital.

“Community paramedics offer extensive background experience and will provide for better access to health care,” Oscarson said. “Nevada now has an opportunity to fill unmet or unrealized community primary care and health needs. Using EMS providers in an expanded role will increase patient access to primary and preventive care, save health care dollars and improve patient outcomes.”

Nevada Gov. Brian Sandoval signed the bill into law on May 25, 2015. The bill allowed the state to write necessary rules for implementation on Jan. 1, 2016.

In late August, Nevada received approval of a state plan amendment from the Centers for Medicare and Medicaid to provide Medicaid reimbursement for medically necessary community paramedicine. Services must be part of the care plan ordered by the patient’s primary care provider and may include evaluation and health assessments; chronic disease prevention, monitoring and education; medication compliance; and immunizations.

“With approval of Medicaid reimbursement, I see tremendous opportunities opening up for Nevada,” said Oscarson.

Starting with Minnesota in 2011, 16 states and the District of Columbia have passed laws on community paramedicine. North Dakota dipped its toes in the water in 2013 with a feasibility study and by 2015 adopted statewide rules. In 2016, the West Virginia legislature authorized six demonstration sites. North Carolina and Maine provide some state funding to support community paramedicine efforts and Minnesota also has secured Medicaid reimbursement.

Janet Haebler, senior associate director of state government affairs for the American Nurses Association, said community paramedicine “strives to fill in gaps in services that previously had been provided by public health and home care nurses but were lost with funding cuts.”

Haebler underscored the necessity of a clear definition of the community paramedic role with patients, as well as the roles of all health team members who deliver such care. For that reason, in states with new community paramedicine laws, nurses have come to the table with EMTs and others to ensure that every patient has access to high-quality care from all health care providers.

In some communities and states, community paramedicine is part of a larger reform called mobile integrated health care. Mobile integrated health care includes services such as providing telephone advice to 911 callers instead of ambulance dispatch; providing community paramedicine care, chronic disease management, preventive care or post-discharge follow-up visits; and transport or referral to an array of health care settings beyond hospital emergency departments.

“We use a nurse to triage calls that come into our 911 number,” said Matt Zavadsky, director of public affairs for MedStar Mobile Healthcare, the ambulance service for Forth Worth, Texas, and 14 nearby cities that serve nearly a million people. “If you have twisted your ankle, for instance, our nurse may suggest that you go directly to an orthopedic clinic. We can even send a taxi to transport you.”

Zavadsky said Texas’ Section 1115 Medicaid waiver provides for reimbursement of the full array of mobile integrated health care services, including community paramedicine. But the waiver doesn’t eliminate the dilemma that ambulances are paid as transportation services, not health care services, under both Medicaid and Medicare. Transportation by the ambulance to a setting other than a hospital emergency room is not reimbursable, neither is providing medical treatment without accompanying transportation service.

“It doesn’t make sense that our ambulance can arrive and provide glucose for a diabetic who has forgotten to eat and is unconscious, treat the patient effectively and arrange for a follow-up visit to the patient’s physician, but not get paid unless the ambulance takes the patient to the hospital emergency department,” said Zavadsky.

Zavadsky and other members of the EMT community are working to change federal policy to make ambulance assessment and referral a reimbursable Medicaid and Medicare service, something they hope can make a significant impact on many individuals who need more accessible care and save money for the health care system overall.

Original article by Deborah Miller, and can be accessed here.

September 1, 2016

Freestanding emergency rooms are expanding fast in North Texas. You can hardly drive down any major street in Dallas without seeing one. But are they good for patients?

Park Cities, Allen and Plano are the newest locations for these slick and efficient facilities that claim the capabilities and services of full-service emergency rooms, guaranteeing treatment without the wait of a hospital-based emergency room. In a sense, patients receive the convenience of an urgent care center, but they anticipate receiving the same quality of a hospital emergency service.

Unfortunately, urgent care is not the same as emergency care, and freestanding emergency rooms simply cannot provide the same level of emergency treatment as hospitals. Urgent care centers, or walk-in clinics, are usually open outside of regular business hours, including evenings and weekends. They are ideal for treating minor injuries, such as sprains, or illnesses like fever or sore throat. Emergency rooms — open 24/7 — are the best place for treating severe or life-threatening conditions. True ERs can handle trauma, X-rays and surgical procedures and have access to specialists.

The freestanding emergency room concept is not new. According to health care management consultant Cherilyn G. Murer, the facilities were established in the early 1970s to expand services to underserved and critical-access areas that cannot support the economic obligations of a dedicated hospital. The increased demand for emergency care has prompted the growth of these types of emergency rooms, as hospitals cut back on emergency departments.

It is expensive to sustain a full-service hospital with surgical suites and sophisticated imaging capabilities. It is even more difficult in smaller, rural communities.

In response, freestanding emergency rooms provide immediate care, with less urgent patients treated and discharged, and more complicated cases transferred immediately to affiliated hospitals with more robust facilities. It seems like a perfect solution to provide appropriate and quality care throughout the region.

Unfortunately, innovative medical entrepreneurs recognize an opportunity to label urgent care services as emergency room care and are able to charge accordingly. A typical urgent care visit may cost $50. But re-label it as an emergency room visit, and your average charge inflates to more than $300. Not a bad pricing strategy.

Freestanding emergency room advocates claim that consumers resent long waits in hospital emergency rooms and prefer a more convenient, efficient solution. While this may be true in some cases, we should also recognize that hospital-based emergency rooms are staffed with trained technicians and clinicians prepared to respond to the most critically ill. A burst appendix, full cardiac arrest or a severe stroke all require immediate surgical or diagnostic intervention.

A fully staffed surgical suite is available 24/7. The cardiac catheterization department times “door-to-needle” care, and the MRI is always available along with technicians for immediate treatment. Suffering a stroke? Clinicians are standing by to administer clot-busting medicines or initiate other protocols for emergent care. These are just a few examples of the preparation and readiness that a hospital-based emergency room provides. And consumers expect this level of care.

What they don’t realize is that a freestanding emergency room is ill-equipped to treat these types of illnesses. Instead, the patient will be diagnosed and then transferred to a hospital-based emergency room for treatment. This wastes critical time to treatment and generates additional expenses for the second emergency room care.

But perhaps even less consumer friendly are the exorbitant charges incurred by the growing number of patients at freestanding emergency rooms. The arriving patient might pay a minimal co-pay or even a no-pay; however, consumers complain about charges after they leave. They are often bombarded with uncovered charges due to insurance plan design or high-end deductibles.

Freestanding emergency rooms are an example of health care entrepreneurs responding to consumer demands with good intentions to benefit economic interests. However, in many cases, these facilities stray far from the original intent to provide care in underserved areas and may even cost patients precious time for treatment in hospitals.

Britt Berrett is director of the undergraduate program in Healthcare Management in the Naveen Jindal School of Management at UT Dallas. Email: britt.berrett@utdallas.edu

Original article can be accessed here.

Fort Wayne, IN – At the 2016 Emergency Response Conference on August 26, 2016, Fort Wayne’s 911 and non-emergency ambulance service provider, Three Rivers Ambulance Authority (“TRAA”) was selected as the State’s 2016 recipient of the “ALS Provider of the Year”. The annual recipient of this award is chosen by committee members of the Indiana Association of Cities and Towns and is given to the ambulance provider that most exemplifies the highest standards in areas such as professional accreditations received, involvement in community-wide public education programs as well as other areas of community involvement. TRAA was one of eight finalists for this prestigious award. Additionally, TRAA dispatcher Rita Hughes was awarded the 2016 “Dispatcher of the Year” awarding, recognizing her for her excellence in the performance of her duties. “We are extremely honored to receive this award” said Gary Booher, Executive Director of TRAA, “It’s the recognition of the dedication that all of our staff has to serving our community with the highest quality of care possible each and every day.”

For more coverage, access the TRAA website here.

August 29th, 2016

A Facebook post, a shared photo, a video on Periscope: What do all of these things have in common? The first answer is that EMTs and paramedics have lost their jobs over such things. The second is that the ripple effect of these events places an unexpected spotlight on agencies where an EMS chief faces the inevitable media question: “What can you do to reassure the public this is an isolated incident?”

When you receive this question from the press, you better hope you have enough goodwill on your side to help make your case. You may love to hate them, but the media can be your friend if you play nicely. So what does that mean?

“We have to realize we must interface with the media,” says Matt Zavadsky, MS-HSA, EMT, public affairs director at MedStar Mobile Healthcare in Ft. Worth, TX. “We cannot pretend they do not exist, or that if we mind our own business we’ll never have to deal with them. Further, to be the kind of responsible community partner we want to be, we often need to educate the community through the media on important issues and happenings.”

Key to this interface is providing story leads to help a reporter fill those slow news days. “Media ride-alongs are great opportunities,” says Zavadsky. “Create a culture within your agency that embraces and enhances media interactions. It’s also a good idea to regularly remind your team members that your ‘brand’ is one of your most important assets and everything they do has an impact on that brand.”

“EMS providers are so busy doing the work every day that they have limited time to focus on building positive community relations. The presenters for this session will provide numerous easy-to-implement strategies that will make it easy to promote the positive!” notes Zavadsky.

The workshop will cover how to:

• Interpret how national and local issues may impact your agency;
• Stay informed about issues impacting EMS and healthcare;
• Create newsworthy stories for positive press coverage;
• Develop key message points that are honest but minimize potential negative perceptions;
• Build effective relationships with local stakeholders, including the media;
• Conduct an interview with helpful and hostile reporters;
• Create a social media presence that promotes both your agency and public health issues to your community.

Additional faculty includes Rob Luckritz, Esq., EMS director for Jersey City Medical Center; Carissa Caramanis O’Brien, EMT-B, president of Red Box Communications; and Rob Lawrence, MCMI, is chief operating officer of the Richmond (VA) Ambulance Authority.

Allison Braxton-Baehr a FOX 8 News Orleans reporter, will make a special guest appearance to share her top advice on working with the media.

Continue this discussion with Matt and the Team at EMS World Expo, where they will cohost a half-day workshop, “PR Boot Camp: An Exercise in Positive Press,” on October 4.

Register at EMSWorldExpo.com. E-mail your media success stories to editor@emsworld.com.

Original article written by Nancy Perry, and can be accessed here.

August 19th, 2016

As more hospitals and healthcare facilities move away from a fee-for-service model, they may find it difficult to apply alternative payment models to the emergency department, frequently a safety net for patients who may be uninsured or unable to pay for care.

The ED also presents challenges because emergency care isn’t set up to follow patients after discharge, which makes it difficult for organizations to obtain a full grasp on care costs, according to new study published in the American Journal of Managed Care. Furthermore, ER doctors may order a large number of tests to rule out life-threatening conditions for patients, so payment reform may lead to misdiagnoses as care patterns change, study authors note.

Despite the unique challenges the ED presents to payment reform, the report’s authors examine how payment models under the Department of Health and Human Services’ four-category framework could work.

In addition to using the existing fee-for-service model, they suggest that organizations could:

Connect the fee-for-service model to quality benchmarks. In this model, according to the study, EDs would still operate under a fee-for-service system, but they could earn additional payments by achieving certain goals, like improving patient satisfaction or better care coordination. Being paid directly for coordination of care can lead to better outcomes and lower costs, according to the study.

Build a new payment model based on fee-for-service. One way this could work is for providers to establish frequent use programs, which cut costs by personalizing plans for patients with more complex medical, psychological and social needs. EDs could also offer bundled payments for more episodic conditions, which may reduce both costs and unnecessary readmissions, according to the study.

Create a population-based payment system. Under this model, ED providers would be paid a fixed sum based on local population, previous emergency care use or projected costs across a certain window of time. Basing payments around population gives incentives to providers to address inefficient care and to prevent unneeded ER visits for acute care.

Here’s the link to the AJMC Study:

http://www.ajmc.com/journals/issue/2016/2016-vol22-n8/aligning-payment-reform-and-delivery-innovation-in-emergency-care

Original article written by Paige Minemyer, and can be accessed here.

AIMHI Commentary: Interesting reading – while these concepts are used to apply to EDs, they certainly could apply to other safety net healthcare providers such as EMS.

MedStar paramedic Jason Hernandez is profiled in the national news magazine, The Atlantic.

The Atlantic, based in Washington, D.C., is a literary and cultural commentary magazine, with a national reputation as a high-quality monthly publication. The magazine focuses on foreign affairs, politics, and the economy, as well as cultural trends aimed at a target audience of serious national readers and thought leaders. The magazine is subscribed to by over 400,000 readers and publishes ten times a year.

MedStar was asked to provide a paramedic for this profile by the National Association of EMTs, after they were contacted by The Atlantic for an EMS professional they could profile in their publication.

Congratulations, Jason!

Click on the link below to view the on-line version of the story:

http://www.theatlantic.com/business/archive/2016/08/paramedic/497300/

CBS-11 Traffic Reporter Chelsey Davis kicked off her new segment “Chelsey’s Hero’s” with a profile of MedStar Emergency Vehicle Technician Josh Enlow!!

Click here to view the news story…