Ems System Performance-Based Funding And Reimbursement Model - Finance Committee Draft Advisory Page 15
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34Finance Committee DRAFT Advisory
EMS System Performance-based Funding and Reimbursement Model
3. Develop national set of performance standards for minimum levels of service taking the
following factors into consideration
a. Clinical Sophistication (EMR, EMT, Advanced EMT, Paramedic)
b. Response Performance
c. Quality (Accreditation, STEMI, Stroke, Trauma Programs)
d. Cost and Cost Savings (Current and Downstream)
e. Surge Capacity
f. Geographic Diversity
g. Population Density
h. Age of Population
i. Other Evidence-based Standards
4. Develop economic models to determine cost of the defined EMS functions at a level
necessary to achieve the identified performance standards
5. Develop sustainable funding models that incorporate all the EMS functions and adequately
recognize the contributions of EMS Systems to health care, public health, public safety, and
emergency medical preparedness
6. Identify necessary actions to effectively implement funding models based on performance
a. Congressional action
b. CMS rule changes
c. State insurance statutes/regulatory changes
d. Creation of appropriate model insurance contracts/payment provisions
e. Federal, State, and local funding options
Conclusion 3. The Finance Committee recognizes that EMS functions are a combination of
government requirements and services driven by user demand and payer requirements. It is
expected that both public funding and user fees will continue to be primary funding mechanisms
in the future. The summary matrix below attributes EMS functions and proposed anticipated
funding to either User Fees via Payers or EMS System via Government (public tax dollars).
Therefore, the pathway to move EMS response to a more sustainable readiness-based funding
and reimbursement mechanism must incorporate all of these functions.
March 29,2012
Draft Advisory
15
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