How to Save $10 Billion Annually with EMS 4.0
Before the COVID-19 pandemic, the Emergency Triage, Treat, and Transport (ET3) pilot program was launched to facilitate diagnosis and treatment of patients beyond a hospital’s walls, particularly in ambulances “in the field”, with the goals of delivering health care services more efficiently and reducing unnecessary Emergency Department (ED) visits. The program was designed to align the incentives for EMS services so patients were treated in the care setting that made the most sense, i.e., EMS would be paid for providing mobile health care rather than only after transporting a patient to the ED. Five years later, with Americans more than comfortable receiving care via telemedicine, the health care industry is well-positioned to expand these services on a wider scale as video-enabled EMS 4.0, saving potentially $10 billion annually across the nation.
Prior to the introduction of ET3, a study performed by Premier Inc. revealed that roughly 30 percent of ED visits were prompted by issues that could have been managed in an ambulatory care setting such as a physician office, health care clinic, or urgent care center—in other words, these were non-emergency issues. In addition, under the traditional CMS payment model, emergency transport companies were found to lose roughly $2.7 billion annually due to treating patients in place because without transport, these cases were not eligible for reimbursement. The novelty of ET3 was the ability to compensate EMS companies for treating patients on-site regardless of whether the patient was taken to the ED.
The authors suggested that having reliable access to more preventative and proactive care in the lower-cost ambulatory setting can help reduce avoidable ED visits and unnecessary hospitalizations. By treating low-acuity cases in outpatient clinics and taking a more proactive approach to patient health, we can better manage chronic conditions and prevent health issues from escalating to the point of requiring emergency care. This shift to proactive, mobile health care delivery is made possible by the industry transition to EMS 4.0, particularly using telemedicine to triage remotely and utilizing AI-enhanced data analysis to personalize care for each patient.
Notably, a large portion of ED visits is comprised of just three types of chronic conditions: behavioral health, hypertension, and diabetes. With improved management of and access to care, this segment of the patient population should be able to obtain the care they need in a more convenient and cost-effective environment than the ED. The researchers estimate that significantly reducing the incidence of ED visits triggered by these three conditions alone could save potentially $8.1 billion each year.
Between the reimbursement of mobile health care and the avoidance of lost revenue due to lack of transport, the total impact of EMS 4.0 could reach over $10 billion annually in savings. However, making this a reality could prove tricky if the infrastructure is inadequate or unreliable, as is often the case; one might wonder if perhaps this is why the ET3 pilot program recorded lower participation rates than expected and suffered an early shutdown in late 2023. After all, only successfully completed sessions could be reimbursed; interrupted telemedicine consultations constitute a loss to the provider.
Thus, to fully realize the potential gains of health care delivery in a mobile environment, we must have a dependable, high-quality telehealth platform so that providers can consistently diagnose and treat patients outside the hospital’s walls—without interruptions. Many telemedicine systems are easily disabled by poor network conditions or inconsistent cellular signals and are not yet ready to fully embrace EMS 4.0. On the other hand, swyMed has proven its capability of creating and holding a steady connection even in challenging environments.
As with any endeavor, having the right tools makes a successful outcome more likely. With $10 billion at stakelearn more about how swyMed can help.
