The Tale of Two Studies…and…COVID-19


At this very moment, 365 days ago, if you would have looked at me and said “COVID-19”, I’d have said “gesundheit!” and handed you a tissue to wipe your nose. No pun intended (well maybe a little pun), but who in the world would have dared to guess that COVID-19 would derail the two most impactful EMS studies in decades…ET3 and Cost Data Collection?

The Tale of Two Studies…and…COVID-19

All of the world stood still…literally!

When we awoke in April to find COVID on our doorsteps, Cost Data Collection was moving into full gear. ET3- not the phone home alien guy, but the Emergency Triage, Treat and Transport voluntary, five-year payment study- was about to begin…and then…BAM!…in rushes COVID and suddenly all of the world stood still…literally!

ET3- to the front of the line!

Following the initial shock, when the dust settled and we became acutely aware our world was changing, we learned that Cost Data Collection was delayed and ET3 was put on hold…well, at least the ET3 study.

With the formal project on mute, the functional part of ET3 was pushed to the front of the line kicking and screaming, becoming reality almost overnight thanks to COVID.

Frankly, that’s not a bad thing.

Telehealth became a necessity and transporting patients to alternative destinations had to happen to segregate patients infected by COVID. To heck with the study, we’re doing the live remote version and flying by the seat of our pants! EMS was uniquely poised to be the boots on the ground, as usual, and so here we set out to blaze new trails even before we can study the impact.

Study we will!

Study we will! That’s beginning right now.

Remember, ET3’s stated purpose is to prove that both treatment-in-place and the ability to transport to alternate destinations (urgent care centers, clinics, etc.) versus completing transports to hospitals and/or skilled nursing facilities (SNFs) was how EMS can help Medicare and other payers save money.

Whether a selected participant of ET3 or not, special allowances known as “Blanket Waivers” or Section 1135 Waivers, gave the EMS community the ability to by-pass transporting to traditional destinations…yet, still be paid to cover our costs to provide the service.

Moving from “ambulance drivers” to health care providers didn’t require a report…just a purpose. And…COVID-19 is that purpose.

To the back burner…Cost Data Collection

While ET3 got a boost, Cost Data Collection got shoved to the back burner.

First, the project was delayed, and then delayed again. The problem is now the bean counters who are going to tally the results of the project are going to be inundated with double the data. Following that, they will be crunched to make sense of the data in order to deliver to Congress using the initial program deadline.

Why not just push the deadline back, you ask?

Because that deadline is important in order to fuel the potential re-tooling of the Medicare Ambulance Fee Schedule which has been broken almost since day one. There is the added urgency we must all place on this project due to the potential for the bonus payments’ expiring at the end of 2022. Congress made it clear bonus payments are in peril without their ability to understand what ambulance costs are. So, no Cost Data Collection project means Congress has no idea what our costs are and we’re back to square one all over again!

But, we should all be ticked that there are these delays, anyway. Allow me to opinionate for a minute because this part stinks!

Why would CMS impose the delays and not care to see how our costs have mushroomed thanks to the pandemic? Isn’t that what happens in EMS…we budget and get ready to spend only to find out that all of our assumptions have changed and now we need more money?

The change hoisted upon us here by COVID is that it upended and delayed a raw deep dive into how costs can rapidly fluctuate based on external variables that are beyond our control. When the hammer drops, such as it did in March and April 2020…there’s no time to react. EMS is alerted and we respond. Then later, we count all the dollar signs!

So, the very fact that we are kicking this can down the road and ignoring 2020 as an anomaly is just plain stupid!

Where do we stand today?

ET3 is ramping back up, catapulted to the center of attention out of necessity. Cost Data Collection is “on hold” because someone in Washington made a bad call. On the street, we’re reacting, adapting and doing the job.

The tally comes later.

Studies and programs come and go. Details at 11!

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