Ems System Performance-Based Funding And Reimbursement Model - Finance Committee Draft Advisory Page 26
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34Comments
Additional funding would boost these essential activities for accident prevention and wellness promotion
Systems should move towards regionalized systems with improved local coordination
Increases in scope of practice increase costs of service; need more research on medically‐appropriate level of care
RT greatest driver of CR; need more research on evidence‐base for local RT requirements; system financing key component of EMS system performance
Reference NHTSA EMS Workforce Paper; no change
EMS agencies sometimes fund oversight via franchise fee paid to local government; agencies often self fund accreditation (CAAS, CAMTS, ACE)
No change
No change; funding required in order to strengthen evidence base
No change; costs included in GAO Cost Categories Tab
No change
No change
Insurers must adequately fund
New service lines required, such as, continuum of care role, expanded IAED PSIAM, nurse advice capacity
Population based funding from local govt for initial access to 9‐1‐1 medical care; need to address indirect cost of FR resupply by trans provider
Establish payments for medically justified treat/release; repatriate downstream savings; need to account for additional liability costs due to non‐trans
Establish ALS payments for on scene treatment according to certain local protocols
Establish payments for treatments under current protocols following patient transport refusals, i.e., diabetic and asthma patients
Limited situations as referenced in NAEMSP Paper with additional research necessary; healthcare facility could be primary payer as HCR evolves
All insurers (govt and commercial) need to pay for cost of readiness; costs included in GAO Cost Categories Tab
Consider expanded use in rural areas via existing NY‐only Medicare reimbursement mechanism [FURTHER DIALOGUE NEEDED]
Level of transport determined by medically appropriate level of care; post‐service utilization review must be medically appropriate (PCS issue)
Payers pay full cost of readiness using Prudent Layperson standard; efforts to reduce readmissions recognize PL standard; HCR reduces # of uninsured
Level of transport determined by medically appropriate level of care [NEW COMMENT]
Limited situations as referenced in NAEMSP Paper with additional research necessary
With the exception of insurance reimbursment for actual transports, government is primary funding source for disaster planning
No change
No change
No change
No change
No change; generally transports under mutual aid agreements are covered by insurance reimbursement
No change
Reduce ambulance diversion, eliminate patient parking at hospitals
Explore new models of care under HCR using existing EMS capacity
DRAFT
4
Revised 11‐08‐11
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