Healthcare environments of all kinds—emergency departments (ED), urgent care centers, acute care hospitals, and so on—share common goals to deliver high-quality and cost-effective, patient-centered care. When these healthcare settings were first established, their systems were designed for treatment efficacy and workflow efficiency. Like all things in life, systems and processes must evolve alongside the changing needs and demands of the world—a concept that has been stifled in healthcare due to its critical yet sensitive nature, long-standing regulations, and cumbersome change management.
As a result, today’s healthcare industry faces a global issue concerning the high costs of low-value care. The prevalence of this issue stems from outdated systems and processes leading to excessive spending, wasted patient and clinician time, and poorer patient outcomes. A specific example of how these outdated systems negatively impact cost, time, and care quality is inappropriate ED utilization.
A recent report by the Center for Health Solutions at Deloitte sheds further light on this issue, stating, “The convenience of the ED, lack of access to a primary care physicians and alternative care settings, socioeconomic deprivation and lack of social support systems, lack of information about more appropriate sites of care—all these factors and more play a role in driving inappropriate ED utilization.”
By diverting non-urgent ED use to alternative healthcare settings, a US study projects a potential $4.4B in annual savings for healthcare systems. All of these factors make a compelling case for change but beg the question: How can the healthcare industry adapt while ensuring patients still receive the care they need?
In this blog, we will dive deeper into this paradigm and set forth solutions for how the healthcare industry, specifically the system of Emergency Medical Services (EMS), can combat high costs for low-value care through a new initiative from CMS encouraging telehealth-based solutions.
EMS Transport Initiative Opens the Opportunity for Tele-EMS
In March 2020, the Centers for Medicare & Medicaid Services (CMS) made strides in combatting the issue of high costs for low-value care with the Emergency Triage, Treat, and Transport (ET3) initiative.
Previous Medicare regulations inadvertently perpetuated the use of hospital EDs, only allowing payment for emergency ambulance transport services to hospitals, critical access hospitals, skilled nursing facilities, and dialysis centers, instead of payment for EMS non-emergency transport to lower-acuity destinations that may be more appropriate for the individuals’ circumstance.
The ET3 initiative is a voluntary, five-year payment model that “aims to improve quality and lower costs by reducing avoidable transports to the ED and unnecessary hospitalizations.” It allows people to access the most appropriate emergency services, paying beneficiaries for:
- EMS transport to a hospital emergency department or other covered destination
- EMS transport to an alternative destination partner, such as a primary care office
- Initiating or facilitating treatment in place with a qualified healthcare partner, either at the scene of the 911 emergency response or via telehealth
Participants of the ET3 program have an open opportunity to reduce expenditures and enhance quality of care. Opportunity also presents itself to non-participating providers, as telehealth services have become more accessible during COVID-19—a shift primarily attributed to Congress, CMS, and other federal agencies waiving restrictions previously applied to telehealth services and Medicare telehealth.
Realizing the Value of Tele-EMS in Your ED
Physician staffing and management companies such as Keystone Healthcare help hospitals effectively adopt, integrate, and optimize telehealth solutions. For entities just starting with Tele-EMS or wanting to supplement existing programs, companies like Keystone Healthcare can help achieve those goals.
Keystone Healthcare offers a variety of telehealth programs. For Emergency Departments specifically, we provide a Tele-EMS platform that connects ED providers on-demand with local EMS or Mobile Urgent Care providers. This program uses technology to triage, treat, and transport patients to the ED or an alternate destination of care within the hospital system. Additionally, Keystone Healthcare offers a direct-to-consumer platform that allows patients to virtually connect to ED providers from the comfort of their homes, providing a seamless transition from the home to the ED when necessary.
Continue reading to see how Keystone Healthcare is supporting Mercy Flight, Inc. with Tele-EMS services in response to CMS’s ET3 initiative.
Keystone Healthcare to Support Mercy Flight with Tele-EMS
Recently, Western Regional Emergency Medical Advisory Committee (WREMAC) in Western New York approved a partnership between Keystone Healthcare and Mercy Flight, Inc., an independent, not-for-profit provider of emergency and non-emergency air and ground medical transport services.
The partnership supports CMS’s ET3 initiative, aiming to improve EMS efficiency in rural areas and encouraging appropriate utilization of EMS by providing treatment in place with Tele-EMS support. Together, Keystone Healthcare and Mercy Flight will leverage telehealth equipment and technologies that enable providers to connect via telehealth from any device anywhere. Other features of the partnership program include:
- Specific training for the providers who will be providing and conducting the telehealth visits
- Board-certified or board-eligible emergency medicine providers to field the calls in real time
- Quality assurance and quality improvement plans to include 100% chart audits during the program
- Metrics such as utilization, downtime, request to provider time, total scene time, post telehealth ED admissions, diagnoses, and disposition to be monitored
This partnership centers on cost-effective, high-quality, patient-centered care that improves EMS efficiency, encourages appropriate EMS utilization, and provides treatment in place with Tele-EMS.
What Does the Future of Telehealth Look Like in Your Hospital?
The issue of high cost for low-value care is systemic, impacting healthcare systems, both global and domestic. There has been awareness surrounding this issue for years, but now, healthcare systems and policymakers are setting forth the infrastructure and solutions necessary for change. Through Tele-EMS and initiatives like ET3 that support the effective and efficient use of telehealth, clinicians and hospitals have more capacity and methods for providing cost-effective, high-quality, and patient-centered care.
What does the future of telehealth look like in your hospital? We can help. Contact us today.