June 20, 2024

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The Ways and Means to ensure resilient emergency medical care

In this episode of the EMS One-Stop podcast, Dr. Edward Racht and Matt Zavadsky join Rob Lawrence to discuss their recent attendance at the U.S. House Committee on Ways & Means hearing on “Access to Health Care in America: Ensuring Resilient Emergency Medical Care,” which took place in an off-site hearing in Denton, Texas, on March 18, 2024.

Dr. Racht, chief medical officer of Global Medical Response; and Zavadsky, chief transformation officer for the Metropolitan Area EMS Authority (MedStar Mobile Healthcare) discuss the evidence and the key issues they conveyed to the committee.

Dr. Racht’s testimony included:

  • The significant advancements made in emergency medicine over the past decades, leading to reduced mortality and disability rates for patients.
  • The importance of updating Medicare reimbursement rates for ambulance services, which have not been revised for over 20 years.
  • Advocating for wholesale reform of Medicare’s coverage of emergency medical services to align with contemporary practices, such as covering treatment in place and transportation to alternative healthcare sites.
  • Matt Zavadsky’s testimony included:
  • The impact of CMS payment policies on EMS, which incentivize unnecessary transportation of patients to the emergency room.
  • Innovative programs initiated by EMS agencies to prevent unnecessary 911 calls and navigate patients to appropriate care settings.
  • Legislative changes required to provide EMS with flexibility in patient navigation, including treatment in place and transport to alternate destinations.
  • The challenges faced by ambulance services nationwide, especially in rural areas, exacerbated by the COVID-19 pandemic.

Top quotes from this episode

“We are the front of the frontline in medicine.” — Dr. Ed Racht

“Our coordinated and integrated EMS and healthcare system now gives gravely injured patients … the opportunity for rapid surgical intervention and a chance at full recovery.” — Dr. Ed Racht

“Emergency healthcare professionals pride ourselves on our ability to dramatically decrease morbidity and mortality from unexpected and sudden illness and injury.” — Dr. Ed Racht

“CMS payment policy is such that we are incentivized to transport every 911 patient to the ER because that is the only time we get paid.” — Matt Zavadsky

“Ambulance services are a vital component of our local and national healthcare and emergency response systems.” — Matt Zavadsky

“Innovative EMS agencies … have initiated patient-centric programs designed to prevent 911 calls and navigate patients to the most appropriate care setting.” — Matt Zavadsky

“Ambulance services across the nation, especially in rural areas, are facing unprecedented challenges.” — Matt Zavadsky

Episode contents

0:05 – Introduction

0:55 – Guest introduction

1:40 – Explaining the Ways and Means Committee

2:30 – We are being noticed!

3:40 – Preparing for a congressional hearing

5:40 – The impact of having a congressional hearing in an EMS location

5:58 – The genuine interest of the committee members

9:00 – Dr. Ed Racht testimony to the Congressional Ways and Means Committee

14:24 – Matt Zavadsky testimony to the Congressional Ways and Means Committee

20:52 – Dr. Racht and Zavadsky’s reactions to the evidence they gave and the feedback

29:00 – Zavadsky’s key points he wished to reinforce during his evidence session

31:45 – Balanced billing, patient protections and removing the patient from the middle of the process

32:50 – Independent Dispute Resolution (IDR) and its challenges.

38:29 – Questions for Secretary Becerra on Capitol Hill

44:00 – Final thoughts

45:00 – A call to action to become one and present a united front “When we unify, we are unstoppable.”

48:00 – You the listener are the great politician

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