MedPac Meeting RECAP (3/6/25): Ground Ambulance Data

The Medicare Payment Advisory Committee (MedPAC) held the first of several Commission discussions related to the statutorily mandated report to review ground ambulance payment policy in light of the Ground Ambulance Data Collection System on March 6, 2025. In addition to the Ground Ambulance Payment Report, the agenda covered physician fee schedules updates, updates on reduction in cost-sharing for critical access hospital outpatient services, an overview of Medicare insurance agents, overview on Medigap, overview on home health care in Medicare Advantage, and institutional special needs plans.

The Bipartisan Budget Act (BBA) of 2018 required CMS to collect data on ground ambulance services through the Ground Ambulance Data Collection System (GADCS). MedPAC must analyze this data to assess Medicare payment adequacy and geographic cost variations, with a report due by June 15, 2026. Commissioners will review the data and guide the workplan. The American Ambulance Association noted the analysis will include cost data stratification by service type and level, as well as potential staffing differences. It will also examine data from a range of organizations, challenges for rural and super-rural providers, and comparisons of rural definitions. Additional focus areas include hospital vs. on-scene treatment, ownership data, treatment in place, payment impacts on response and transport decisions, the effect of “wall time” on costs, and differences between “loaded” and “unloaded” miles. 

MedPac Mandated Report: Payment for Ground Ambulance Services

Stay tuned for more information and updates on upcoming MedPac meetings!

The International Journal of Emergency Medicine Continuous published an article on a study that evaluates the impact of the American Heart Association's Mission Lifeline initiative on STEMI care in Polk County Fire Rescue (PCFR). By analyzing EMS data from 2015 to 2023, researchers found that Mission Lifeline protocols, such as prehospital 12-lead ECGs and hospital pre-activation, significantly improved EMS-to-balloon (E2B) times and STEMI triage accuracy. The percentage of patients meeting the 90-minute E2B time improved from 74% in 2015 to 84% in 2019, while under-triage rates dropped below 1% after 2020. These findings highlight the effectiveness of standardized, protocol-driven EMS interventions in optimizing STEMI care and improving patient outcomes.

EmergencyInsights - Infectious Disease Preparedness

EMS providers face significant risks from infectious diseases while responding to emergencies. Common threats include respiratory viruses, tuberculosis, hepatitis, HIV, meningitis, MRSA, and gastrointestinal illnesses. Effective infection control measures—such as proper PPE use, hand hygiene, sharps safety, equipment decontamination, vaccination, and exposure management—are crucial for reducing transmission. EMS agencies must ensure ongoing training, stockpile essential supplies, and implement outbreak response protocols. By staying informed and following best practices, EMS professionals can protect themselves, their patients, and the public while delivering high-quality care.

Learn More Here

JEMS: Safe guarding EMS Clinician Data

The Interstate Commission for EMS Personnel Practice has adopted Position Paper 2025-01 to strengthen data security protections for EMS clinicians. Amid rising cyber threats, EMS personnel face increased risks of identity theft and data breaches due to inconsistent licensure data safeguards. The Commission’s initiative aims to balance credential transparency with security by limiting public access to sensitive information, restricting bulk data disclosures, and implementing stricter verification processes. Recognizing EMS data protection as a national security issue, the Commission urges all states to adopt these standards, ensuring EMS professionals receive the same protections as other frontline responders.

https://www.jems.com/ems-management/safeguarding-ems-clinician-data-a-critical-step-in-protecting-the-workforce/

JEMS: EMS Staffing White Paper Released by NAEMT

Emergency Medical Services (EMS) play a critical role in saving lives and protecting communities. While traditional models focus on rapid response and ALS staffing, research shows that most EMS calls don’t require lifesaving interventions. This presents an opportunity to optimize resources while continuing to deliver high-quality care.

Key Challenges Faced by EMS:

• Workforce Shortages: Despite an increase in certified EMTs and paramedics, EMS agencies struggle to fill field positions due to low wages, burnout, and competition from other healthcare sectors.
• Financial Strain: EMS agencies often operate under financial pressure, with reimbursement rates falling short of covering operational costs, leading to service cuts and staff reductions.
• Unrealistic Expectations: While fast response times are important in critical cases, studies show that for most calls, patient outcomes are not impacted by rapid arrival times, allowing for smarter deployment strategies.

Solutions to Empower EMS:

• Tiered Response Models: Implementing a combination of ALS and BLS responses ensures critical patients receive advanced care while maintaining system efficiency.
• Evidence-Based Response Times: Aligning response time goals with clinical needs prioritizes patient outcomes and reduces unnecessary strain on EMS resources.
• Innovative Dispatch Strategies: Utilizing triage systems, telemedicine, and non-ambulance personnel for low-acuity calls ensures ambulances remain available for life-threatening emergencies.

Conclusion:
EMS providers are the backbone of community health and safety. By embracing data-driven strategies and flexible response models, we can strengthen EMS systems, support frontline providers, and ensure high-quality care for every patient. Investing in EMS means investing in safer, healthier communities.

EMS Staffing White Paper Released by NAEMT - JEMS: EMS, Emergency Medical Services - Training, Paramedic, EMT News

The document, An International Community Paramedic Career Structure: A Synthesis of the Literature, Regulatory Frameworks, and Community Paramedicine Expert Advice, investigates the emergence and structuring of community paramedicine (CP) as an essential extension of emergency medical services (EMS). This review synthesizes findings from global research, regulatory standards, and expert consultations to establish a career framework for community paramedics.

Key insights include:

• Core Competencies: Identifies the unique skillsets required for community paramedics, blending emergency response capabilities with public health and primary care knowledge to address underserved and remote populations.

• Training and Education: Highlights the need for specialized and standardized educational pathways that align with international best practices, ensuring community paramedics are adequately prepared for expanded roles.

• Integration with Healthcare Systems: Stresses the importance of community paramedicine being recognized as an integral part of broader health systems to enhance access to care and reduce strain on emergency departments and hospitals.

• Regulatory Support: Advocates for uniformity in certification and licensure processes to ensure career mobility and adherence to a standard scope of practice across jurisdictions.

• Sustainability: Emphasizes the role of structured career progression, ongoing professional development, and supportive workplace policies in sustaining a skilled CP workforce.

This comprehensive approach aims to enhance the effectiveness, accessibility, and continuity of community-based care, positioning community paramedic programs as a vital solution to contemporary healthcare challenges.

Assessment of The ImPACTS Project

An article recently published in the Pediatric Emergency Care journal discusses how the ImPACTS program (Improving Acute Care Through Simulation) fosters partnerships between pediatric specialty centers (hubs) and general emergency departments (spokes) to enhance pediatric care through simulation-based training. The study highlighted key success factors, including strong institutional support, leadership buy-in, effective communication, and the role of Pediatric Emergency Care Coordinators (PECCs). Barriers like resource logistics and lack of engagement were mitigated through collaboration. Outcomes included improved pediatric readiness, stronger clinical education, and enhanced institutional partnerships. 

HHS Strategic Plan for Use of AI Release

The U.S. Department of Health and Human Services (HHS) released its AI Strategic Plan on January 10, 2025, detailing a roadmap to responsibly implement artificial intelligence (AI) in healthcare, human services, and public health. The Plan focuses on improving safety, accessibility, equity, and health outcomes through AI while mitigating risks.

Key Goals of the Plan:

1. Catalyzing AI Innovation: Accelerating breakthroughs to enhance people's health and well-being.
2. Promoting Responsible AI Use: Ensuring ethical and safe adoption of AI to minimize potential harm.
3. Democratizing AI Access: Facilitating equitable availability of AI technologies for all.
4. Cultivating AI-Ready Workforce: Equipping staff with skills and resources to effectively integrate AI.

The Plan builds on existing HHS initiatives and includes regular updates, risk assessments, and stakeholder engagement to adapt to the rapidly evolving AI landscape. It aims to position HHS as a global leader in advancing AI responsibly, protecting patient safety, and promoting equity in its deployment across healthcare systems.

McKinsey & Company: What to expect in US healthcare in 2025 

The McKinsey & Company article "What to expect in US healthcare in 2025 and beyond" highlights key trends anticipated to shape the healthcare landscape in 2025:

• Patient Affordability and Cost Containment: Efforts to reduce out-of-pocket expenses and enhance price transparency are expected to continue, influenced by legislative measures like the Inflation Reduction Act, which aims to lower Medicare prescription costs.

• Shift Toward Non-Acute Care Delivery: There's a projected movement from traditional hospital settings to non-acute care environments, including increased care provided at home. This transition is facilitated by advancements in healthcare technology and a focus on patient convenience.

• Growth in Healthcare Technology and Specialty Services: Segments such as healthcare software, data analytics, and specialty pharmacy services are anticipated to experience significant growth, reflecting the industry's emphasis on digital transformation and personalized care.

EMS Now: Trends to Watch in 2025

The article "EMS Trends to Watch in 2025" from EMSNOW explores key challenges and trends within the EMS industry for 2025, building upon the difficulties faced in 2024. Key points include:

1. Demand Uncertainty: EMS companies must carefully navigate market predictions, particularly in sectors like medical, automotive, and defense, as growth is difficult to forecast.
2. Inventory Visibility: Following pandemic-driven disruptions, EMS companies are struggling with high levels of inventory and need better forecasting data to manage component acquisitions effectively.
3. Workforce Challenges: The rise in labor costs in low-cost regions is making workforce recruitment and retention difficult, especially with lower demand leading to fewer hours.
4. Automation: More investment is being made in automating repetitive tasks in the manufacturing process, though high-mix, low-volume manufacturing continues to face challenges.
5. Reshoring/Regionalization: The industry anticipates a continued shift toward localizing manufacturing due to geopolitical issues, with countries aiming for the "China Plus One" strategy.
6. Regional Manufacturing Ecosystem: Rebuilding the regional electronics supply chain, including PCBs, will be crucial for future stability and security in the industry.
7. Macroeconomic Factors: Global tensions and economic shifts may impact the EMS market, with expected growth slowing until late 2025.

While 2025 may not be as challenging as 2024, the industry will need to adjust to these trends for sustained growth.