GA EMS Toolkit
Healthcare reform was intended to reduce the payout from insurance payors to healthcare providers, and to tie payments to the quality of provider performance. While it is arguable that quality is improving, there is no doubt that reimbursement is declining. Coupled with that decline is the fact that the cost of providing healthcare is not going down, in fact it is increasing. The inverse relationship between reimbursement and cost is a growing challenge for ambulance service suppliers across the country.
Currently, most major insurance payors, including Medicare and Medicaid, do not pay for EMT or paramedic services outside of an ambulance transport. However, that is changing. The Minnesota Department of Human Services now pays for Ambulance response and no treatment codes. In Pennsylvania there is proposed legislation, House Bill 1013, that states reimbursement will be required if emergency services are rendered and transport was declined. And Blue Cross Blue Shield in several states (CA, CO, CT, GA, IN, KY, ME, MO, NV, NH, NY, OH, VA, WI) has announced payment for treatment without transport. With these changes, community paramedicine will have an opportunity to move forward, and ambulance service providers will finally be paid for what they do outside of the vehicle. However, with this change comes with new challenges. The resources on this page are designed to help you prepare for and benefit from these changes.
Funding provided by the Georgia Department of Community Health State Office of Rural Health in accordance with Grant #17048G