EMS provider determinations of necessity for transport and reimbursement for EMS response, medical care, and transport: combined resource document for the National Association of EMS Physicians position statements

Millin, Michael G., Brown, Lawrence H., and Schwartz, Brian (2011) EMS provider determinations of necessity for transport and reimbursement for EMS response, medical care, and transport: combined resource document for the National Association of EMS Physicians position statements. Prehospital Emergency Care, 15 (4). pp. 562-569.

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Abstract

With increasing demands for emergency medical services (EMS), many EMS jurisdictions are utilizing EMS provider initiated nontransport policies as a method to offload potentially nonemergent patients from the EMS system. EMS provider determination of medical necessity, resulting in nontransport of patients, has the potential to avert unnecessary emergency department visits. However, EMS systems that utilize these policies must have additional education for the providers, a quality improvement process, and active physician oversight. In addition, EMS provider determination of nontransport for a specific situation should be supported by evidence in the peer-reviewed literature that the practice is safe. Further, EMS systems that do not utilize these programs should not be financially penalized. Payment for EMS services should be based on the prudent layperson standard. EMS systems that do utilize nontransport policies should be appropriately reimbursed, as this represents potential cost savings to the health care system.

Item ID: 18353
Item Type: Article (Research - C1)
ISSN: 1545-0066
Keywords: emergency medical technicians; paramedics; transportation of patients; determination of medical needs; health services misuse; emergency medical services; reimbursement
Date Deposited: 12 Oct 2011 05:08
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110305 Emergency Medicine @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111709 Health Care Administration @ 50%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920299 Health and Support Services not elsewhere classified @ 50%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 50%
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