RT Journal
A1 Munjal K, Carr B
T1 REaligning reimbursement policy and financial incentives to support patient-centered out-of-hospital care
JF JAMA
JO JAMA
YR 2013
FD February 20
VO 309
IS 7
SP 667
OP 668
DO 10.1001/jama.2012.211273
UL http://dx.doi.org/10.1001/jama.2012.211273
AB 
Retrospective studies estimate that between 7% and 34% of Medicare patients transported by ambulance to an emergency department could have been safely treated in an alternate environment.1- 2 However, Medicare and other payers provide no reimbursement for out-of-hospital care including response, triage, and patient assessment and treatment unless the patient is transported to an emergency department. The Medicare ambulance billing guide states, “The Medicare ambulance benefit is a transportation benefit and without a transport there is no benefit.”3 With most private insurers mimicking Medicare,2 this payment policy significantly affects the behavior of EMS agencies contributing to an inefficient use of out-of-hospital care resources.