Ems System Performance-Based Funding And Reimbursement Model - Finance Committee Draft Advisory Page 18
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34Finance Committee DRAFT Advisory
EMS System Performance-based Funding and Reimbursement Model
3. Cost of Readiness. NHTSA and FICEMS should adopt the IOM’s definition for cost
of readiness and ensure that accounting for that cost is included in the EMS finance
study.
4. Finance Models. Models should address both current and proposed future cost and
revenue potentials.
a. Finance models must recognize the cost of EMS functions and analyze the
positive impact of EMS response on the health care system, public health systems,
public safety system, and emergency medical preparedness system; and potential
funding streams from the various disciplines.
b. Finance models must specifically address direct and indirect grant, tax, and user
fee funding sources.
• Recommendation 3: NHTSA should sponsor a Stakeholder’s Committee that includes
EMS response, hospital, and public health administrators, educators, medical oversight,
and economists to develop a template to calculate the financial impact (and other
considerations) to upgrade the currently provided service to the minimum standards or
beyond the minimum standards when advancing the EMS system’s scope of service.
Examples include: Treat without transport options, alternative response considerations,
STEMI and stroke programs, the use of CPAP and other new treatment options,
community paramedicine, population health, and hospital/ED readmission abatement
initiatives. The template should also calculate potential downstream savings to the
healthcare system to help the EMS System determine cost versus benefit.
• Recommendation 4: NHTSA should establish EMS-specific definitions of charity care
and uncompensated care for both policy and tax purposes. NHTSA should also identify
new finance models for funding the current significant uncompensated care burden
carried by EMS Systems in order to transition away from shifting the cost of this care to
commercial insurers.
• Recommendation 5: NHTSA should establish EMS-specific measures for evaluating
access to EMS in order to address federal access to care standards and to address local,
state and federal mandates to provide emergency care regardless of reimbursement
amounts.
Federal Interagency Committee on EMS
• Recommendation 6: NHTSA and FICEMS should endorse the IOM’s recommendations
for encouraging improved coordination, expanded regionalization, and increased
transparency and accountability to advance EMS performance standards in preparation
for future pay for performance initiatives. This endorsement should support data linkages
between EMS and hospitals to report patient outcomes, policy and procedure
development for continuous improvement, and sponsoring a Stakeholder’s Committee to
adopt patient outcome definitions and goals for EMS Systems.
• Recommendation 7: NHTSA and FICEMS should declare EMS to be an essential
service and formally recognize, beyond its healthcare function, the role of EMS Systems
March 29,2012
Draft Advisory
18
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