States Step In to Pay for Treatment Without Transport as Federal Paramedicine Reimbursement Lags

The COVID-19 pandemic has placed a spotlight on the growing value of treating patients with minor or manageable symptoms in their homes and avoiding costly hospital visits. However, treatment without transport continues to be largely undervalued and widely goes unreimbursed.

A number of states are now showing how things can be done differently by offering new reimbursement models for treatment without transport.

The most recent example comes out of Oregon. This year as the pandemic peaked, Oregon partnered with the Centers for Medicare and Medicaid Services to issue a temporary state plan to significantly raise reimbursement rates for treat-in-place incidents from $54.45 to $420.62. Oregon recognized the value of paramedicine and telehealth at-home care at the height of a national public health crisis, acknowledging that an increase in COVID-19 related aid calls put a strain on community resources. While this measure is temporary, it could pave the way for permanent regulations in the state, and serve as a model to other states.

Elsewhere across the country, Minnesota’s Medicaid system reimburses treatment without transport at $222.05. Going back even further, Georgia’s Medicaid system began reimbursing for treatment without transport two full years before COVID-19, beginning in 2018.

Meanwhile at the federal level, community paramedicine services continue to go uncompensated, and while the ET3 model proposed by Medicare seeks to change the current model, it’s been slow-going. Where the real opportunities for change lie may be with state legislators. Community paramedicine centers are being encouraged to reach out to their state lawmakers, cite the examples in Oregon, Minnesota, and Georgia, and advocate for reimbursement of at-home, treatment-in-place care, especially as our nation finds its way through this pandemic.