Medicare will start paying ambulances for taking patients to healthcare facilities other than the emergency department under a plan the Trump administration rolled out Thursday.
“Medicare only pays if they bring you to the hospital, or a few alternative sites, which you may not need, which may be really expensive, and may not be the best place for you to get care,” said Health and Human Services Secretary Alex Azar, speaking at a press conference held at a fire department in southwest Washington, D.C.
Medicare, for the most part, reimburses ambulances if they take patients to a hospital emergency department, which can result in crowded hospitals, expensive care, and long waits for patients. The new plan, which is voluntary and will be called the “Emergency Triage, Treat, and Transport” model, is part of the Trump administration’s goal under Azar to help deliver healthcare services more effectively and at a lower cost.
The plan would allow for reimbursing ambulances and medics for caring for patients at the site of the medical emergency, whether at home or elsewhere, or alternatively would allow for reimbursing patients for calling in a doctor through telehealth.
Seema Verma, administrator for the Centers for Medicare and Medicaid Services, cited as an example a scenario in which a woman covered by Medicare has diabetes and faces a drop in blood sugar while she is out shopping.
After 911 is called and first responders arrive, doctors could care for the patient where she is, bring in doctors through telehealth, take her to an urgent care clinic, or take her to her doctor, and still be reimbursed by Medicare.
“A value-based healthcare system will help deliver each patient the right care, at the right price, in the right setting, from the right provider,” Azar said.
Verma said that patients out-of-pocket costs wouldn’t change as far as the ambulance is concerned, but expected that patients would save money by avoiding the out-of-pocket costs they would face at the emergency department. Ambulance suppliers could earn more from Medicare after a few years if they try the new model and are successful.
Adam Boehler, director of the Center for Medicare and Medicaid Innovation, said patients could still go to the emergency department if they prefer.
“If the patient wants to go to the hospital, they have the same protections they have today and that will be enforced the same way,” he said.
