Medicare Advantage 101: New policy series explains Medicare Advantage and its role within the Medicare system.
Today, the Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—announced a new model within traditional Medicare that could help people with Medicare avoid unnecessary trips to the Emergency Department. This new model would allow emergency transportation services to take individuals to their primary care doctor or urgent care, or to deliver treatment in place, when the person does not need to be seen in an emergency room.
Currently, most emergency transportation after a 911 call is limited to taking the patient to the Emergency Department of a nearby hospital. This can mean that Medicare beneficiaries are exposed to the expense and stress of an emergency room visit when they may really need to see their primary care doctor or to receive limited treatment in their homes. The Emergency Triage, Treat and Transport (ET3) model would allow participating ambulance suppliers and providers to partner with providers to deliver treatment in place when appropriate. This could be either on-the-scene or through telehealth. When such treatment is not appropriate but the condition does not require immediate transportation to an Emergency Department, the model would allow the ambulance to deliver the patient to alternative destination sites such as primary care doctors’ offices or urgent-care clinics.
The details of such models are extremely important and CMS must ensure that people with Medicare receive appropriate care when they face a medical emergency. We welcome efforts to keep people out of the Emergency Department when safe and feasible, though we cannot be sure yet if this model will have the necessary safeguards.
We will continue to monitor this model and other models CMS publishes to ensure they support high-quality, affordable care for people with Medicare.
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