Georgia Medicaid to Pay for Treatment on Scene, Alternative Destinations for EMS

Excited to see Payers making changes to reimbursement in an effort to improve EMS Service delivery – Michael Shabkie

In early 2017 the Georgia State Office of Rural Health (SORH) submitted three proposals to the Georgia Medicaid office requesting changes to reimbursement for EMS.

The proposals requested consideration of reimbursing EMS for 1) treatment of patients without transport, 2) transporting patients to destinations other than hospitals, and 3) mobile integrated healthcare/community paramedicine (MIH-CP) programs.

Traditionally EMS services have only been paid when a patient was picked up and taken to an emergency room. These changes would allow for payment to EMS providers for the care they give, regardless of where that care takes place or where the patient needs to go.

Georgia Medicaid has now approved treatment without transport and transport to alternative destinations for reimbursement. It will submit the MIH-CP proposal to the Centers for Medicare and Medicaid Services (CMS) for approval in the coming months.

Assuming no unforeseen barriers, treatment-without-transport payments will be effective beginning April 1, 2018. Submission of claim for reimbursements under code A0998 will require that the response originate through a 9-1-1 call and that the patient receive treatment with pharmaceuticals before refusing transport to the hospital.

The intent behind this proposal is to allow EMS to recover some of the costs associated with providing medications to patients who ultimately choose not to be transported for continuation of care.

The payment for this service will be set at $48.28. Medicaid is the second major healthcare payer to announce payment for this service in Georgia, following the January announcement that Anthem/BCBS would pay for EMS treatment of patients without transport.

Payments for transport to alternative destinations is targeted to start July 1, 2018. Submission of claims will require that the response originate through a 9-1-1-type call; the existence of an approved protocol signed by the agency medical director specific to patient evaluation and transport to an alternative facility; documentation of the patient’s agreement to go to an alternative facility; and a written agreement between EMS and the receiving facility.

The intent behind this proposal is to allow EMS an opportunity to transport properly screened patients who have noncritical conditions to facilities appropriate for their needs, thereby reducing overcrowding of hospital emergency departments and allowing patients to receive medical attention in a less costly setting.

This option may also allow counties with no local hospital and/or limited ambulance coverage to shorten turnaround times and keep resources within county borders for longer periods while at the same time giving their patients a level of care commensurate with their condition. The payment for these transports will be the same as other Medicaid transports for the same code.

Please keep in mind that all Medicaid claims are subject to review and audit; therefore, proper documentation on the patient care report is essential, and all required supporting documents must be maintained and provided upon request.

Georgia has long been on the leading edge of innovative changes in EMS models, in 2015 becoming one of the first states to add EMS as an “origination site” for telemedicine. Currently only four states have received approval from CMS for Medicaid reimbursement for MIH-CP programs: West Virginia, North Carolina, Minnesota, and California. Georgia Medicaid will submit a proposal that’s structured similarly to those that have received CMS approval and anticipates this proposal will also be approved later this year. However, this is still uncertain, and confirmation of this change will be contingent upon CMS approval.

If approved, Georgia will take yet another step into the future of more effective ambulance service models. The State Office of Rural Health will keep EMS partners informed of the progress of this proposal as it works its way through CMS review.

The State Office of Rural Health and EMS Consultants have put together a “tool kit” with documents necessary to take advantage of these changes. For model forms and training/educational materials, go to www.emscltd.com/gaemstoolkit.

Christopher Kelly is a lawyer who focuses on regulatory healthcare law as it relates to the EMS and ambulance industry. This article is not intended as legal advice. For more information, contact Chris at EMS Consultants, Ltd., 800/342-5460, or e-mail ckelly@emscltd.com. 

EMS Consultants, Ltd.

Read original article here: https://www.emsworld.com/article/219934/georgia-medicaid-pay-treatment-scene-alternative-destinations

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Leading Non-Emergency Medical Transportation Company Bringing Heart Safe Environment and Driver Certification Process to Their Customers

Helping professionalize the NEMT industry – Michael Shabkie

Company leadership along with key industry partner, Michael Shabkie, looking to professionalize the industry by educating and training their medical transportation drivers.

Dependable Medical Transport Services (DMTS), a non-emergent transportation company, based in Phoenix, Arizona, announced that its focus on safe, efficient transportation and extraordinary customer care will be further enhanced by placing Automatic External Defibrillators (AED’s) in each Paratransit van along with the implementation of a Certified Transport Specialist Program.

DMTS has partnered with Cardiac Science and Priority One Ventures to provide Powerheart(R) AED’s, and a complete AED Program management solution.

Furthermore, DMTS’s industry leading driver certification program will ensure that all vehicle operators become Certified Transport Specialists (CTS).

DMTS Certified Transport Specialists complete instruction on a variety of safety elements including, but not limited to, First Aid, Automatic External Defibrillator (AED), Continuous Chest Compressions (CCC) training as well as Customer Service and Advanced Driver Education.

“We are committed to customer safety and satisfaction and believe our investment in certifying our employees will establish us as an industry leader,” said Terry Reilly, Vice President of DMTS. “Our Certified Transport Specialists (CTS), are trained to activate the emergency response system (911) and have access to an easy-to-use AED.

The comprehensive training our employees receive will not only positively affect our clients, but will affect their families and facilities they reside in. We strongly encourage other non-emergent transportation providers to follow our lead”.

“Since we have been using DMTS for transport services, we have found that they are striving for excellence in a very competitive market”, said Lisa Harrison, Administrator for Scottsdale Heritage Court, A Life Care Center of America Facility. By adding these new training elements, they continue to enhance their commitment to customer safety as they provide a vital service to our residents”.

Since its inception, DMTS has been providing high quality non-emergent transportation services throughout Arizona. With a fleet size of over 60 specially equipped vans, DMTS provides transportation to approximately customers throughout Maricopa and Pinal Counties.

 

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Right Response, Right Treatment, Right Transportation, Right Destination. Each and Every Time! Engage911 – Engage911 Showcase Page

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Ambulance Use Down 7%, Patients Access Care Via Rideshare

Less expensive Uber rides are on the rise as fewer patients access care via ambulance, a new study shows.

Article by Sara Heath

Shared by Michael Shabkie at Engage911.net

 – Rideshare services such as Uber are revolutionizing the way patients access care, with far more patients opting for an Uber than an ambulance ride during a non-life-threatening medical emergency, according to a working paper out of the University of Kansas.

An analysis of ambulance utilization in over 750 cities in the 43 states in which Uber operated between 2013 and 2015 revealed that patients are opting for the cheapest version of healthcare transportation. Since Uber’s arrival in each city, ambulance utilization dropped by an average of 7 percent, the researchers found.

This trend aligns with overall industry efforts to deliver the highest quality of care at the lowest cost possible, said co-author David Slusky, assistant professor of economics at KU.

“In order to lower health care spending while improving health outcomes, people can use the least-skilled professional who is still qualified,” Slusky said in a statement. “It’s the same in the provider space: you don’t need a neurosurgeon to diagnose strep throat.”

A similar mindset applies to using Uber in place of traditional ambulance transportation. A patient might need to visit the emergency department, but does not require medical attention on the way there.

“Many patients don’t need something that can break traffic laws and don’t need something staffed by paramedics with a bunch of fancy equipment,” Slusky said.

In turn, opting to use an Uber can save patients thousands of dollars. Ambulance rides are notoriously expensive, so selecting a less costly but still effective alternative is a step forward in value-based care.

There are some alternative explanations, conceded Slusky and co-author Leon Moskatel, of the Department of Medicine at Scripps Mercy Hospital in San Diego. Uber utilization could cut down on the number of unsafe or drunk drivers, ultimately leading to a lower rate of car crashes. Fewer car crashes could mean lower emergency department and ambulance use.

However, the pair asserted that because of mixed evidence their initial hypothesis is more likely. Patients are opting for Uber rides in non-life-threatening situations instead of more expensive ambulances.

This news could have positive implications for the healthcare industry, Slusky and Moskatel said. For one, this trend aligns with industry efforts to deliver high-quality healthcare at the lowest possible cost.

Additionally, patients using Uber are making it easier for patients truly in need to access ambulances. Some health emergencies do require immediate medical attention on the way to the hospital. With fewer non-life-threatening cases using ambulance resources, patients in critical need can access these rides.

“Given that even a reduction of a few minutes can drastically improve survival rates for serious conditions, this could be associated with a substantial welfare improvement,” the researchers said in the paper.

These findings have some policy implications, particularly for healthcare payers. Payers often bear at least some of the cost of an expensive ambulance ride. Payers can reduce their own costs by encouraging patients to use Uber when possible. One strategy is offering patients a $50 gift card to Uber or another ridesharing company, Slusky and Moskatel suggested.

Even simple patient education efforts can motivate patients to access less costly ridesharing options when heading to the emergency department, the researchers said.

“We want to find every way possible to bend the medical cost curve,” Slusky concluded.

Rideshare services such as Uber and Lyft have proven effective solutions to patient care access cost barriers. A 2016 study published in the Journal of the American Medical Association found that Lyft partnerships reduce per-ride costs by 30 percent. Thanks to the program, patients accessing care via Lyft now fact transportation costs between $31.54 and $21.32.

The Lyft partnership also improved patient satisfaction scores by about 80 percent.

As healthcare professionals continue to identify strategies for lowering healthcare costs while increasing quality, they should look into better rideshare partnerships. Ridesharing options offer cost-effective transportation, while also ensuring patients get necessary medical attention.

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Original Articlehttps://patientengagementhit.com/news/ambulance-use-down-7-patients-access-care-via-rideshare

 

 

 

 

 

 

 

 

 

 

 

Engage911 Launches New Ambulance and NEMT Industry Consultant Website

Engage911 is a leading medical transportation organization offering the tools, training, and leadership to generate significant growth in revenue and run volume for medical transportation organizations throughout the U.S.
Michael Shabkie
PHOENIX – Feb. 7, 2018 – PRLog — Engage911 announced today the launch of its next-generation website, www.engage911.net. The new site features enhancements including current ambulance and healthcare industry news as well as new, emerging blog content on best practices and emerging healthcare technologies.

The site can also be accessed from mobile devices, allowing for submission of inquiries and easy access for clients to manage their projects with a secure client portal.

Engage911 is led by Michael Shabkie, (http://www.engage911.net/) an industry leading consultant with a 25+ year record of successfully developing Emergency Medical Systems, ambulance and non-emergent transportation (NEMT) operations as well as, implementing revenue generating marketing and business development initiatives for their clients.

About Engage911

When it comes to increasing revenue, winning contracts, and capturing market share, don’t leave it to chance. With over 25 years of experience in the areas of marketing, operations, finance, process improvement, human resources; let’s take your company to the next level.

•NEMT and Ambulance Marketing Strategies to Significantly Increase Revenue
•Due Diligence Expertise Related to the Acquisition or Merger of Medical Transportation Companies
•Developed Successful RFP Responses Worth Over $250 Million for Leading Companies Nationwide
• Experienced Expert Witness on EMS Related Issues
•NEMT System Development and Implementation of Best Practices
•Ambulance Marketing Software Development
•Educational Seminars in Providing Exceptional Customer Service for the EMS Professional
* Intensive 2 Day Marketing Boot Camps and Ongoing Training for Marketing Personnel
•Innovative Contracting Strategies for the Private Sector
• Comprehensive EMS System Evaluations for Elected Officials
• Budget and Financial Analysis for Start Up Operations
• EMS System Design and Start Up Expertise for Private Ambulance Organizations
• Contract Performance Analysis for Public or Private EMS Providers and the Cities They Serve
• EMS Demand Analysis and RFP Development for Municipalities
• EMS Equipment Acquisition
• Development of EMS Public/Private Partnerships

Contact: Michael Shabkie at michael@engage911.net

Media Contact
Michael Shabkie
***@engage911.net
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https://www.prlog.org/12691073-engage911-launches-new-ambulance-and-nemt-industry-consultant-website.html?embed

Thinking About Starting a Non Emergency Medical Transportation (NEMT) or Ambulance Company?

Creating a Solid Business Plan is Your Road Map to Success When Starting an NEMT or Ambulance Company – Michael Shabkie

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Arizona Cardinal Stadium EMS Partnership Kicked Off By Setting New Guinness World Record

Glendale, AZ- The Glendale Fire Department and Southwest Ambulance announced it they have been awarded a contract to serve as emergency medical providers at the new Cardinals Stadium in Glendale, Arizona. The contract was signed following their joint proposal to the Arizona Sports and Tourism Authority and Global Spectrum.

“We believe the collaboration of Southwest Ambulance and the Glendale Fire Department at Cardinals Stadium will create the ideal partnership for ensuring the safety of our guests” stated Peter C. Sullivan, General Manager for Global Spectrum at Cardinals Stadium.

“Glendale Fire and Southwest crews do a great job working together on Glendale streets and have been for 20 years,” said Glendale Fire Chief Mark Burdick. “We look forward to that experienced teamwork continuing inside the Stadium.”

“Glendale Fire and Southwest just marked our 20th year working together to ensure the public’s safety,” said Barry Landon, President of Southwest Ambulance. “We’re very excited that our trusted relationship led to this joint proposal.”

The contract will cover all Stadium events with the agencies working together to provide medical coverage from first aid to life threatening emergencies including ambulance transportation. For larger events, Glendale Fire and Southwest will set up an entire command and control center, including radio operations for onsite medical personnel.

“Working together, the Glendale Fire and Southwest are ready to care for the emergency medical needs of Cardinals Stadium patrons,” said Mike Shabkie, Vice President at Southwest Ambulance who oversees the company’s West Valley 911 system.

On July 29th, prior to the stadium’s first event in August, Southwest Ambulance and Glendale Fire taught 1039 new Stadium employees how to use an Automated External Defibrillator (AED), establishing a new Guinness World Record for Largest AED Training Session.

The record was set during a pep rally and customer service training event organized by Global Spectrum. The training was especially appropriate since Global Spectrum strategically placed several of the life saving AED devices around the Stadium should an event patron suffer a Sudden Cardiac Arrest.

The AEDs and training were coordinated through Southwest’s Project Heartbeat Public Access Defibrillator program. The record is pending a final review by Guinness World Records.

Shared by: @MichaelShabkie

Michael Shabkie