Legislative Updates

CMS Announces New Emergency Triage, Treat, and Transport (ET3) Mode


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While it’s unclear if any agency in Missouri will be selected for this, we believe it is worth at least alerting our membership to this just in case an agency does apply. Applications wouldn’t be available until at least this summer.

On Thursday, the Centers for Medicare & Medicaid Services (CMS) released a five-year, voluntary payment model through the Centefor Medicare and Medicaid Innovation (CMMI) called the Emergency Triage, Treat and Transport (ET3) Model. The stated goal of the model is to provide greater flexibility to ambulance care teams to address emergency health care needs of Medicare beneficiaries following a 911 call.

Currently, Medicare typically only pays for unscheduled ambulance services to take patients to hospital EDs. The ET3 model would provide for two alternative ambulance payments: (1) payment for treating the patient in place with a qualified health care practitioner (NPs, PAs, or physicians), either on the scene or connected using telehealth; and 2) payment for unscheduled transportation to alternative destinations such as primary care providers or urgent care clinics. These new payments would be accompanied by a value incentive strategy, in which participating providers would earn up to a 5 percent payment adjustment based on quality measures. The model will apply to Medicare fee-for-service beneficiaries, but CMS hopes to involve other public and private payers as well.

CMS only released a fact sheet on Thursday. The agency plans on issuing a request for applications this summer. The request for applications should include more details about how the model would operate.

CMS hopes to attract applicants from across the country. Once provider participants have been announced, CMS will offer funding to up to 40 entities that run 911 dispatches in communities where providers have been selected to participate. The model will officially start on January 1, 2020.