In Arkansas, a new rule will begin January 1, 2024, allowing ambulance services to triage, treat, and transport patients to alternative destinations, including urgent care centers, physician offices, and behavioral health facilities. However, the ambulance service will be on-task to first coordinate the patient’s care with a physician or a behavioral health specialist via telemedicine. Insurers will also be required to cover 911-initiated ambulance dispatch resulting in telemedicine triage, transportation to the alternative destination, and/or treatment in place.
Can your UC manage ambulance arrivals, and do you even want to? According to Alan Ayers, President of Experity Consulting, it’s ironic this program begins on the cusp of the Centers for Medicare and Medicaid Services shutting down its voluntary 5-year Emergency Triage, Treat and Transport pilot (known as “ET3”), due to disappointing participation numbers. “Without additional payment for doing so, many urgent care operators have practical concerns about accepting ambulance arrivals,” Ayers says. He specifies that the rule could result in:
- Increased risk of inappropriate patients brought directly to the urgent care, including patients needing hospital admission
- Triage based on insurance or ability to pay, especially if the urgent care is private, doesn’t offer charity care, requires upfront payment for self-pay, etc.
- Higher-acuity and more time-consuming patients for urgent care, which could create a potential drag on margins
- Risk of more patients who balk at following up in the urgent care and simply go home, “against medical advice”