Dec. 10, 2013: NJHA Offices are closed due to inclement weather.
The federal government could save $560 million or more a year if Medicare had the flexibility to reimburse emergency medical services (EMS) for managing selected 911 calls other than transport to an emergency department, according to a new study published in Health Affairs.
The savings could be even greater – as much as twice that amount – if private insurance companies also had that flexibility, the study found.
Researchers examined Medicare claims data from 2005 to 2009 and estimated that as many as 16 percent of Medicare-covered 911 EMS transports involved conditions that were not emergencies or ones that a primary care provider could handle.
Among Medicare beneficiaries not admitted to the hospital, nearly 34.5 percent had a low-acuity diagnosis that researchers determined providers outside the ED probably could manage. Annual Medicare EMS and ED payments for these patients were approximately $1 billion per year.