Should Payment Policy Be Changed to Allow a Wider Range of EMS Transport Options?

The Institute of Medicine and other national organizations have asserted that current payment policies strongly discourage emergency medical services (EMS) providers from transporting selected patients who call 911 to non-ED settings (eg, primary care clinics, mental health centers, dialysis centers...

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Bibliographic Details
Published inAnnals of emergency medicine Vol. 63; no. 5; pp. 615 - 626.e5
Main Authors Morganti, Kristy G., PhD, MPH, Alpert, Abby, PhD, Margolis, Gregg, PhD, NREMT-P, Wasserman, Jeffrey, PhD, MS, Kellermann, Arthur L., MD, MPH
Format Journal Article
LanguageEnglish
Published United States Mosby, Inc 01.05.2014
Subjects
Emergency
Emergency Medical Services - economics
Emergency Medical Services - methods
Emergency Medical Services - organization & administration
Emergency Service, Hospital - economics
Emergency Service, Hospital - organization & administration
Health Care Costs
Health Policy
Humans
Reimbursement Mechanisms
Transportation of Patients - economics
Transportation of Patients - methods
Transportation of Patients - organization & administration
United States
United States
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Summary:The Institute of Medicine and other national organizations have asserted that current payment policies strongly discourage emergency medical services (EMS) providers from transporting selected patients who call 911 to non-ED settings (eg, primary care clinics, mental health centers, dialysis centers) or from treating patients on scene. The limited literature available is consistent with the view that current payment policies incentivize transport of all 911 callers to a hospital ED, even those who might be better managed elsewhere. However, the potential benefits and risks of altering existing policy have not been adequately explored. There are theoretical benefits to encouraging EMS personnel to transport selected patients to alternate settings or even to provide definitive treatment on scene; however, existing evidence is insufficient to confirm the feasibility or safety of such a policy. In light of growing concerns about the high cost of emergency care and heavy use of EDs, assessing EMS transport options should be a high-priority topic for outcomes research.
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ISSN:0196-0644
1097-6760
DOI:10.1016/j.annemergmed.2013.09.025