The Center for Medicare and Medicaid Innovation announced Thursday it has selected 205 ambulance providers and suppliers to participate in its new payment model that allows them to transport Medicare beneficiaries to areas besides the emergency department.
The model, unveiled last February and called the Emergency Triage, Treat, and Transport (ET3) Model, is an attempt to discourage unnecessary ED use. Under current payment structures, ambulances usually take patients to EDs regardless if it's appropriate or not because that's the only way they can be reimbursed under Medicare.
"The participants in our ET3 Model will be able to deliver care to patients at the right time and place," CMS Administrator Seema Verma said in a press release.
The CMS notified the 205 applicants of their selection to participate and will release a final list of participants by this spring. The participants overall represent ambulance suppliers and providers across 36 states.
Under the model, ambulances can take patients to a destination other than an ED, such as a doctor's office or initiate treatment on the scene through telehealth. A beneficiary can still choose to be brought to an ED if he or she prefers.
The model relies on ambulance providers to build partnerships with local doctors, urgent care clinics and telehealth providers. By notifying them now, the ambulances have "ample time" to set up the partnerships needed, the CMS said.
Another component of the model involves local and state governments or those they designate to operate 911 calls. CMMI wants these groups to set up medical triage lines so they can help the ambulance providers participating in the model. The CMS plans to issue a notice of funding opportunity for these groups in the spring with applications due in the summer. It's seeking up to 40 groups and the agreements would last for two years.
The ET3 model is slated to begin this spring and last five years.