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ET3 Savings Data Supports EMS Treatment in Place Legislation

Apr 25, 2024

NAEMT received the data in response to a Freedom of Information Act (FOIA) (5 U.S.C. § 552) request seeking documents from the recently ended Emergency Triage, Treatment and Transport (ET3) pilot program. The report shows that the average Net Savings to Medicare (NSM) per Medicare beneficiary was $537.53 when a patient was treated-in-place instead of taking an ambulance ride to the hospital emergency room, which is one of the most expensive places to receive health care. 

EXECUTIVE SUMMARY:  Newly available federal data from the Centers for Medicare & Medicaid Services (CMS) demonstrates more than $500 in Net Savings to Medicare per patient encounter under the recently ended ET3 pilot program. The results validate the need for passage of NAEMT-supported federal legislation to enable payment for EMS Treatment in Place (TIP).

The ET3 program’s per patient savings to the Medicare program was documented in a March 2023 external fiscal analysis presented to CMS as part of the Development of Performance-Based Payment (PBP) Eligibility and Methodology. This data validates the economic value of EMS Treatment in Place (TIP) payment models and the need for Congressional action to enable payment for TIP.

“This data from CMS’ external evaluator proves the significant savings to the Medicare program. We also have patient experience data from patients enrolled in the ET3 program demonstrating that patients who are not transported to the ER have higher patient satisfaction with the EMS response,” said Matt Zavadsky, Chair of NAEMT’s EMS Economics Committee and a member of the CMS ET3 Model Quality Workgroup. “This proves the economic and patient experience benefit of changing the EMS payment model from payment for transport, to payment for the care we provide.”

NAEMT has long advocated for providing ambulance agencies the flexibility to navigate patients to the right care in the right setting through federal and state reimbursement of TIP. Medicare currently does not cover TIP as a benefit; therefore, EMS is not reimbursed for care unless a patient is brought to the hospital. The current EMS economic model incentivizes transportation to a hospital emergency department, even when a less expensive level of care is appropriate.

Reimbursing EMS agencies for TIP will save Medicare billions of dollars on unnecessary emergency department visits, enhance patient experience, shorten task times for EMS agencies struggling with workforce shortages, help decompress overcrowded hospitals and emergency departments, and meet patients’ needs without long waits at the hospital.

To view the ET3 economic evaluation, click here. To view the current legislation in Congress authorizing CMS to pay for TIP, click here and here.