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ET3 Come Home…

By CHELLE CORDERO, Correspondent | August 01, 2020 | NEW YORK

Story No. 070820102


The Federal Center for Medicare and Medicaid Services (CMS) has delayed its rollout of the ET3 Model (Emergency Triage, Treat, and Transport) which is designed to increase efficiency and treatment of patients, give them the care that they need, and reduce unneeded hospital visits and costs. Under this system, which was supposed to begin a five-year period this past May will now begin sometime this fall to allow participating agencies to deal with the volume of COVID-19 emergencies. More than two-dozen NYS agencies applied to be participants in this model run. All agencies need to certify 24/7 availability or present a suitable back-up plan to do so.

Local governments where ambulance agencies are participating in ET3 can apply for funding (NOFO) to establish or expand a medical triage line in their 911 dispatch. All applicants have to implement the model in a state in which at least 15,000 Medicare FFS emergency ambulance transports occurred in 2017or in a region that includes one or more counties in which at least one of those counties had 7,500 Medicare FFS emergency ambulance transports in 2017.

“Emergency Triage, Treat, and Transport (ET3) is a voluntary, five-year payment model that will provide greater flexibility to ambulance care teams to address emergency health care needs of Medicare Fee-for-Service beneficiaries following a 911 call. Under the ET3 model, the Centers for Medicare & Medicaid Services (CMS) will pay participating ambulance suppliers and providers to 1) transport an individual to a hospital emergency department (ED) or other destination covered under the regulations, 2) transport to an alternative destination (such as a primary care doctor’s office or an urgent care clinic), or 3) provide treatment in place with a qualified health care practitioner, either on the scene or connected using telehealth. The model will allow beneficiaries to access the most appropriate emergency services at the right time and place.”

The ultimate goal of the ET3 Model is to provide less expensive care, appropriate treatment and patient choice; if the patient declines any options offered and wants to be treated in an Emergency Department, they must be taken there. By reducing unnecessary transports, maximizing time spent, and keeping costs low, ET3 will help to improve care in otherwise under-served populations. The health care needs of Medicare patients would be met in appropriate situations, on site (possibly including telemedicine options), at a doctor’s office or urgent care center, or if medically necessary or requested by the patient, at the emergency department of a local hospital. CMS encourages agencies get other forms of insurance in compliance as well.

ET3 encourages the use of Community Paramedicine programs while decreasing excess burden on emergency departments. Without the ET3 model, EMS agencies would only receive payment from Medicare agencies if they transported patients to the hospital regardless of actual need; under ET3 agencies can receive payment for appropriate treatment even if it’s in the patient’s own living room. Under the ET3 system 911 call centers will be able to triage patients and dispatch the appropriate services from Community Paramedicine to emergency hospital transport. Putting patient care first, agencies participating in ET3 would be able to bring respiratory infections to urgent centers for treatments, drop chronic inebriates off at detox centers, help uninjured fall victims to identify trip hazards, and provide medication education as needed.

The ET3 system is forward thinking and a better model for care delivery.


This article is a direct street report from our correspondent and has not been edited by the 1st Responder newsroom.