In this post I link to and excerpt from a resource on the Emergency Triage, Treat, and Transport (ET3) Model from the CMS Innovation Center.
“Emergency Triage, Treat, and Transport (ET3) Model” [This link is from The Centers For Medicare And Medicaid Services].
Here are excerpts from the above:
Emergency Triage, Treat, and Transport (ET3) is a voluntary, five-year payment model that will provide greater flexibility to ambulance care teams to address emergency health care needs of Medicare Fee-for-Service (FFS) beneficiaries following a 911 call. Under the ET3 model, the Centers for Medicare & Medicaid Services (CMS) will pay participating ambulance suppliers and providers to 1) transport an individual to a hospital emergency department (ED) or other destination covered under the regulations, 2) transport to an alternative destination partner (such as a primary care doctor’s office or an urgent care clinic), or 3) provide treatment in place with a qualified health care partner, either on the scene or connected using telehealth.
The model will allow beneficiaries to access the most appropriate emergency services at the right time and place. The model will also encourage local governments, their designees, or other entities that operate or have authority over one or more 911 dispatches to promote successful model implementation by establishing a medical triage line for low-acuity 911 calls.
As a result, the ET3 model aims to improve quality and lower costs by reducing avoidable transports to the ED and unnecessary hospitalizations following those transports.
Stay up to date on the latest ET3 Model news and updates by subscribing to the ET3 Model listserv.
Background
Currently, Medicare regulations only allow payment for emergency ground ambulance services when individuals are transported to hospitals, critical access hospitals, skilled nursing facilities, and dialysis centers. Most beneficiaries who call 911 with a medical emergency are therefore transported to one of these facilities, and most often to a hospital ED, even when a lower-acuity destination may more appropriately meet an individual’s needs.
Participation
The key participants of the ET3 model will be Medicare-enrolled ambulance service suppliers and hospital-owned ambulance providers. In addition, to advance regional alignment, local governments, their designees, or other entities that operate or have authority over one or more 911 dispatches in geographic areas where ambulance suppliers and providers have been selected to participate in the model will have an opportunity to access cooperative agreement funding.
Any individual who calls 911 and is connected to a dispatch system that has incorporated a medical triage line under the model would be screened for eligibility for medical triage services prior to ambulance initiation. Upon arriving on scene, participating ambulance suppliers and providers may triage Medicare FFS beneficiaries to one of the model’s interventions upon ambulance dispatch following a 911 call. As part of a multi-payer alignment strategy, the Innovation Center will encourage ET3 model participants to partner with additional payers, including state Medicaid agencies, to provide similar interventions to all people in their geographic areas.
Timing
The ET3 Model will have a five-year performance period. As CMS and ET3 Model selected applicants work to respond to needs due to COVID-19, CMS has decided to delay the start of the ET3 Model from May 1, 2020 until Fall 2020. The performance period for all participants, regardless of start date, will end at the same time; thus, only applicants selected through the first RFA will be able to participate through the full five years.
Webinars
- Emergency Triage, Treat, and Transport (ET3) Model – Overview
- Emergency Triage, Treat, and Transport (ET3) Model – RFA Overview
- Emergency Triage, Treat, and Transport (ET3) Model – Model Application Tutorial
Additional Information
- Ambulances (PDF) – These are the flexibilities offered specifically to ambulances during the Public Health Emergency (PHE) stemming from the Novel Coronavirus Disease (COVID-19).
- ET3 Model Selected Applicants (PDF) – This list is representative of all applicants who have been invited to participate in the ET3 Model. Once Participation Agreements between CMS and the Selected Applicants have been fully executed, CMS will release a final list of ET3 Model Participants.
- Press Release – February 27, 2020
- Fact Sheet – February 14, 2019
- Press Release – February 14, 2019
- ET3 Model Infographic (PDF)
- ET3 Model Participant Partnership Guide (PDF)
- ET3 Model Eligibility Fact Sheet (PDF)
- ET3 Model CMCS Information Bulletin (PDF) – This Information Bulletin provides guidance to states interested in replicating the flexibilities of the ET3 Model within their Medicaid program to develop ET3-aligned interventions.
- Frequently Asked Questions
- Draft HHS / DOT White Paper: Innovation Opportunities for EMS (PDF)
If you are interested in additional information or have questions about the ET3 Model, please review the Frequently Asked Questions page or contact ET3model@cms.hhs.gov.
