News & Winning
Strategies for
EMS Leaders
E
M
S
EMS INSIDER MAY 2014
UNLAWFUL TO COPY WITHOUT THE EXPRESS PERMISSION OF THE PUBLISHER.
TM
MAY 2014
VOLUME 41
NUMBER 5
Some of the most common questions in the development of a Mobile
Integrated Healthcare (MIH) strategy
relate to fnancial sustainability. Yes, it
is the right thing to do for the patients
and it’s necessary to meet the Institute for Healthcare Improvement’s
Triple Aim (improved patient outcomes, improved population health
and reduced cost of care), but without
a sustainable economic model the programs are diffcult to sustain.
Thankfully, innovative economic
models are fourishing. This comes
as a result of healthcare fnancing
changes within the Affordable Care
Act (ACA) that seek to align incentives to help make the entire healthcare delivery system more fnancially
sustainable. We are also seeing implementation of some long-standing, but
stagnant fnance reforms.
Some of the more recognized fnance
changes—such as bundled payments,
risk-sharing arrangements, enhanced
managed Medicare and Medicaid pro-
grams and, of course, Accountable
Care Organizations (ACO)—are ways
the ACA is transforming our health-
care delivery models. However, pro-
grams such as 1115 Medicaid waivers,
managed Medicare and Medicaid, and
traditional fee-for-service models are
rapidly recognizing MIH provides a
valuable service in which they should
be investing.
This is the frst of four columns
that will focus on the fnancing and
economic models for MIH services
that hospitals, Medicare and Medicaid, commercial insurers, integrated
delivery systems, ACOs, hospice agencies and even home health agencies
are funding and, more importantly,
why they are funding them.
The question for this frst article:
What is motivating hospitals today
to work with other agencies to actually reduce the inappropriate use of
their in-patient facilities?
Value-based purchasing
One of the efforts to improve qual-
ity and reduce healthcare costs in
the ACA is an initiative called value-
based purchasing (VBP). Under VBP,
• Percent of heart attack patients
given medication to avert blood
clots within 30 minutes of arrival
at the hospital
• Percent of heart attack patients
given percutaneous coronary inter-
ventions within 90 minutes of arrival
•;Percent;of;heart;failure;patients
It seems the industry is abuzz with
talk about healthcare reform and
how community paramedicine pro-
grams will help to solve the world’s
healthcare woes. While I am a pas-
sionate believer in what this future
holds for our industry, I am also
a realist and pragmatist when it
CONTINUED ON PAGE 2
Mobile Integrated Healthcare: The Payer’s Perspective
Part 1: hospitals as payers
By Matt Zavadsky
CONTINUED ON PAGE 6
INSIDE
4 EXPERT ADVICE
TRACKING DATA FOR
OPTIMAL RESULTS
5 FYI
FDA APPROVES NALOXONE
8 FEDERAL AGENCIES COORDINATE
TO ADVANCE EMS
FICEMS RELEASES ACTION PLAN
Healthcare Reform &
Community Paramedicine
What can you afford to do?
By Jonathan Washko