Air ambulance charges study could boost Senate surprise bill legislation

From Modern Healthcare:

A new study documenting high air ambulance charges could bolster a congressional effort to ban the medical transport companies from balance billing for their services.

In 2016, the national median charges for air ambulance services were 4.1 to 9.5 times what Medicare paid for the same services, according to a study published in Health Affairs on Monday by Johns Hopkins University researchers.

That’s a much higher median charge disparity than for ground ambulance services or for physician services.

Can an Incentive Formula Fix ED Wait Times?

From Emergency Medicine News:

… experts on quality of care in U.S. emergency departments said the authors’ proposal misses the mark on a number of fronts. “They’re ignoring the fact that pay-for-performance schemes already exist in health care, with performance metrics intensely tied to wait times,” said Shari Welch, MD, an emergency physician for more than 26 years, a consultant in health care quality improvement, and a research fellow at the Intermountain Healthcare Delivery Institute in Murray, UT.

“Anyone interested in ED operations lives and breathes wait times like door-to-doc, which is reported to the Centers for Medicare and Medicaid Services and publicly available,” she said. “Many other organizations do this for EDs. But this model takes federal regulation to yet another level, with another bureaucracy to manage and regulators financially penalizing poor performers. There is a lot known about EDs that are nonidentical, and these authors ignore the concept of volume bands and performance.”

ET3 Could Revolutionize EMS Transport

From Emergency Medicine News:

A medical call to 911 usually results in an ambulance at the door and a trip to the hospital. The Centers for Medicare and Medicaid Services, however, is proposing a new model that it promises will lower costs, improve quality of care, and allow patients to receive care at the right place, not necessarily the ED.

They call it Emergency Triage, Transport, and Treat (ET3), and say the plan will reduce the number of unnecessary trips to the emergency department and instead take patients to a clinic or doctor’s office or even set up a telemedicine appointment in their home. CMS will release a request for applications this summer, decide who meets the criteria in the fall, and implement it in early 2020. (

It’s good that the federal government is looking at things through modern eyes, said David Persse, MD, the director of Houston’s EMS and Public Health Authority. “EMS is evolving at an impressive pace, but it is limited in how to evolve depending on how we get paid,” he said. “As the payment model becomes more contemporary, it allows us to become more creative and decrease cost.”

Flu shot was 29% effective this season, CDC says

From Becker’s:

The flu shot’s overall effectiveness during the 2018-19 season was 29 percent, according to CDC data provided to Becker’s.

Health experts presented the flu season data June 27 at a meeting for the CDC’s Advisory Committee on Immunization Practices.

Rural hospital closures leave residents with few options: ‘It’s a fight every day’

From ABC:

Rural hospitals face a variety of challenges. They tend to serve aging communities that suffer from poor health and require expensive treatments. There are often severe doctor shortages in rural areas, and gaps in insurance coverage if patients have insurance at all. And, several studies show that rural hospitals are closing at a faster rate in states that chose not to expand Medicaid coverage to poor residents under Obamacare.

Tennessee is one of those states, and the residents of Jamestown and its neighboring communities fear losing their hospital could cost lives.

“If something happened to our children — we live on a farm and farm machinery and snakes whatever. I’ve always just known that hospital’s there if we need it,” Tracy Wright, a churchgoer, said of the Jamestown center.