Medicare

[daedalus]

Crazy idea came to mind today while I was transporting a patient.

Does medicare recognize EMTs and Paramedics as providers that can be reimbursed for their services? Why not introduce legislation that would force medicare to only reimburse services using paramedics that have Associate level education? And have private insurers follow in suit?

I think that Rid was talking about this somewhere...

 

[fortsmithman]

I'm from Canada and we don't use the associates degree. Our country only uses bachelor master and doctors degree. Here bachelors degrees run between 3 and 4 yrs. We also have community colleges that award 2 year diploma's. Would our community college diploma programs be equivalent to an associates degree.

 

[ffemt8978]

Good idea, but first you've got to get Medicare to pay out at reasonable rates for reimbursement.

 

[TransportJockey]

I'm from Canada and we don't use the associates degree. Our country only uses bachelor master and doctors degree. Here bachelors degrees run between 3 and 4 yrs. We also have community colleges that award 2 year diploma's. Would our community college diploma programs be equivalent to an associates degree.

Yea, your community college diploma is about equal to the US associates degree

 

[fortsmithman]

In Alberta and the NWT all our EMT-P's are all trained to the equivalent level of an associates degree. Because all EMT-P programs are withe exception of one is 2 yrs. The program that isn't 2 yrs is at Medicine Hat College. That program is a 4 yr bachelors degree.

 

[TransportJockey]

Since I'm an idiot and can't figure out how to edit my post, I'll say it in a new one.

Man, am I glad my EMT-P course is an AAS program... Although I wish I could afford the one school here locally that does the BS program, but I guess that will wait when I finish the BS w/ either RN or RRT

 

[ffemt8978]

Not an idiot...the system won't let you edit any post more than 15 minutes old.

 

[fortsmithman]

Here in Canada nearly all provinces and territories do not pay for EMS transport except for those families on welfare income support. Here in the NWT our territorial health plan covers EMS transport for seniors.

 

[Ridryder911]

I do doubt Medicare would even consider making professional payment plan without laughing hysterically and spewing their coffee. It has been a hard debate for even professional level nurses such as Anesthetist, Nurse Practitioners and even licensed psychologist to be paid or reimbursed that have a graduate or even a doctorate level of education.

I would be glad to see services get appropriately reimbursed in comparison to flight services. Even more so those that would meet "above average" requirements obtain a higher level, at least it would be reasonable.

R/r911

 

[rhan101277]

Well doctors get to charge for their services.

 

[Ridryder911]

Well doctors get to charge for their services.

Well, doctors have a license to practice medicine and as well have a formal education. There is much difference between a 500 hour class and 12 years +.

R/r 911

 

[BossyCow]

Let's use one of the most inefficient systems in government today to fix a broken system.. yeah.. that works....

 

[daedalus]

Let's use one of the most inefficient systems in government today to fix a broken system.. yeah.. that works....

In the short term and long run it would save them money by avoiding paying out for certain things, thus helping it relieve its impending demise.

 

[wehttam]

still find i so amazing the standard level of education riquired by other countries for there paramedics and in the great USA they are fighting to make an AAS degree standard hmmmmmm

 

[Veneficus]

still find i so amazing the standard level of education riquired by other countries for there paramedics and in the great USA they are fighting to make an AAS degree standard hmmmmmm

Laborers who want no responsibility, simple task oriented skills, and have no value for education are a large percentage of US EMS.

The US culture in General does not place value on education. Whether it is EMS or graduating high school, we are all about standardized tests and minimum standards. Medic mills are nothing more than expensive test prep classes. I am surprised Kaplan hasn’t jumped on the wagon and opened one yet.

As much as it pains me, I have to say, emergency medical persons just don't have what it takes to bill for their individual performance.

I also think it is tme to forgo trying to save medicare/medicade and figure out what the replacement will be.

 

[VentMedic]

Medicare and Congress love education. The other allied health professions learned this quickly in order to remain as a "business" in the delivery of healthcare. There are reasons why PTs raised their level to Doctorate of Physical Therapy and Masters being an entry level requirement. All of the other therapies that have recognized this love presenting their reimbursement proposals to Congress as a PROFESSION and not 50 individual states with 50 different certs.

I will say RT is lagging but working frantically to catch up. But, RTs have only been licensed in some states for about 20 years. They did have a national certification exam for a lot longer but was not always required since they were just viewed as a tech service provider without professional status. Sound familiar? However, RT is now petitioning Medicare for additional reimbursement opportunites and they are doing this by playing the education card with their national organization, American Association for Respiratory Care, representing them.

From the AARC website:

[FONT=Arial, Helvetica, sans-serif]

[FONT=Arial, Helvetica, sans-serif]Medicare affords a number of advanced-level allied health care providers the privilege of working without direct physician supervision, such as physician assistants, nurse practitioners, and clinical nurse specialists. The AARC Medicare Respiratory Therapy Initiative will give respiratory therapists with an RRT and bachelor’s degree similar recognition that they do not now have.[/FONT]

. [/FONT]

The many different therapists are able to gain support quickly because they also make joint ventures to keep reimbursement for homecare and rehab services FOR THE PATIENTS' BENEFIT. While increases in reimbursement will be good for the therapists for value and job security, they do not petition Congress with the selfish statement of "We want a raise" to make it appear very self-serving. If you can not show through education what you are worth to the patient and NOT what the patient is worth to you, there is little chance EMS will have much of an agrument. If EMS can not collect all 50 states and 50+ different certs into a neat little package to show that they are at least trying to work for the goal of quality patient care, there will not be much of an argument.

 

[vquintessence]

Well, since we're "operating" on minimal standardized tests and essentially stopping forward progress when it comes to higher education, why not have Medicare (or NHTSA / other govt entity) force our hand by requiring a minimum of an Associate Degree for EMS providers as an ultimatum for financial reimbursement. It will help Medicare prolong its inevitable death, who cares if it destroys present day EMS? (I believe the A.D. is basically what Daedalus already proposed.)

Put the medic mills out of business, drastically cut down acceptable technicians to operate vehicles available for IFT, and eradicate many EMS personnel operating in 911 systems across the nation. Hell the new standards should only grandfather the EMS providers who are capable of meeting the new requirements through a "GED for EMS" (the only remaining standardized program that phases itself out). Like Vent said, the ultimatum will create public outcry as well as public interest. Knee jerk reactions cause Congress to act, and blindly throw out money.

Many of us will lose our jobs, but think of it as cutting the fat during a radical liposuction. Desired outcome? Better pt care, better pay/benefits, self gratification backed by a rounded education and not skills, better personal grammar and math skills, some respect among medical community, and help prevent the entry of "I joined EMS as a last resort" type people.

Call me bitter, but the destruction of EMS as it exists will barely create a blink. And if it should fail, oh well. We're heading that direction anyways, and it's tiring to limp through existence as a "profession" that has to constantly justify its own existence for funding.

It gets old hearing FD's attempting to increase their budget demands while EMS, an almost self supporting entity, has to dance and beg for every contract to the amusement of the FD and city council.
I'm sick of reading about FF's/EMT's/P's of the lowest denominator whining about having to meet "new demanding requirements" like changes in treatment modality. For crying out loud, EMS incorporates medicine, and medicine is forever evolving.
etc. etc. etc. I need sleep.

 

[vquintessence]

Crappy internet; double post.