Monday, February 25, 2019

Drones sUAV's for First Responders Part 107 Pilots Could Save Agencies Thousands

Drones are becoming more accepted and the FAA is proposing new rules on flying at night and over people without a Part 107 waiver.

It takes knowledge in a number of subjects from flight rules and regulations to reading and understanding Aeronautical maps like Sectional Charts to pass the FAA test to obtain your Commercial sUAV Certificate. It takes practice and many flight hours to become a proficient sUAV pilot.

Rural first responders could benefit greatly from contracting with Commercial sUAV pilots in rural areas. With helicopter flight costs over $1000 an hour and long response times sUAV's could assist in search and rescue, fire scene size up, or tracking suspects. 

It takes thousands of dollars and many man hours to train a Part 107 sUAV pilot. It would be cost prohibitive for most small agencies or to train each firefighter or resident deputy as a pilot. 

Agencies would be better served if fire chiefs and resident deputies were trained as observers for local sUAV pilots. This has two benefits, it leaves someone from the requesting agency in command of flight operations, and the fire chief or deputy are better trained to gather information for type of operation.

In fire size up an sUAV can be deployed in minutes providing information command needs to know for firefighter safety. 

In some law enforcement operations where weapons are involved it's much safer to use an sUAV than put a helicopter crew at risk. 

The best of both worlds this would bring business to local sUAV pilots with their Part 107 Certification and provides air support to small agencies and rural law enforcement at 1/10th the cost of a helicopter.

According to the Arizona Auditor  it costs DPS Air Rescue Units cost about $1,081 per flight hour to operate and maintain. 


Thursday, February 14, 2019

Big Change EMS can bill for on scene care

EMS Agencies benefit from Medicare's New "Fee For Service" Announcement from HHS today

HHS launches innovative payment model with new treatment and transport options to more appropriately and effectively meet beneficiaries’ emergency needs
Supporting ambulance triage options aims to allow beneficiaries to receive care at the right time and place
Today, the U.S. Department of Health and Human Services (HHS), Center for Medicare and Medicaid Innovation (Innovation Center), which tests innovative payment and service delivery models to lower costs and improve the quality of care, announced a new payment model for emergency ambulance services that aims to allow Medicare Fee-For-Service (FFS) beneficiaries to receive the most appropriate level of care at the right time and place with the potential for lower out-of-pocket costs. 
“This model will create a new set of incentives for emergency transport and care, ensuring patients get convenient, appropriate treatment in whatever setting makes sense for them,” said HHS Secretary Alex Azar. “Today’s announcement shows that we can radically rethink the incentives around care delivery even in one of the trickiest parts of our system. A value-based healthcare system will help deliver each patient the right care, at the right price, in the right setting, from the right provider.”
The new model, the Emergency Triage, Treat and Transport (ET3) model, will make it possible for participating ambulance suppliers and providers to partner with qualified health care practitioners to deliver treatment in place (either on-the-scene or through telehealth) and with alternative destination sites (such as primary care doctors’ offices or urgent-care clinics) to provide care for Medicare beneficiaries following a medical emergency for which they have accessed 911 services. In doing so, the model seeks to engage health care providers across the care continuum to more appropriately and effectively meet beneficiaries’ needs. Additionally, the model will encourage development of medical triage lines for low-acuity 911 calls in regions where participating ambulance suppliers and providers operate. The ET3 model will have a five-year performance period, with an anticipated start date in early 2020.
“The ET3 model is yet another way CMS is transforming America’s healthcare system to deliver better value and results for patients through innovation,” said CMS Administrator Seema Verma. “This model will help make how we pay for care more patient-centric by supporting care in more appropriate settings while saving emergency medical services providers precious time and resources to respond to more serious cases.”
Currently, Medicare primarily pays for unscheduled, emergency ground ambulance services when beneficiaries are transported to a hospital emergency department (ED), creating an incentive to transport all beneficiaries to the hospital even when an alternative treatment option may be more appropriate.  To counter this incentive, the ET3 model will test two new ambulance payments, while continuing to pay for emergency transport for a Medicare beneficiary to a hospital ED or other destination covered under current regulations:
  • payment for treatment in place with a qualified health care practitioner, either on-the-scene or connected using telehealth; and
  • payment for unscheduled, emergency transport of Medicare beneficiaries to alternative destinations (such as 24-hour care clinics) other than destinations covered under current regulations (such as hospital EDs). 
The ET3 model encourages high-quality provision of care by enabling participating ambulance suppliers and providers to earn up to a 5% payment adjustment in later years of the model based on their achievement of key quality measures.  The quality measurement strategy will aim to avoid adding more burden to participants, including minimizing any new reporting requirements.  Qualified health care practitioners or alternative destination sites that partner with participating ambulance suppliers and providers would receive payment as usual under Medicare for any services rendered. 
The model will use a phased approach through multiple application rounds to maximize participation in regions across the country.   In an effort to ensure access to model interventions across all individuals in a region, CMS will encourage ET3 model participants to partner with other payers, including state Medicaid agencies.
CMS anticipates releasing a Request for Applications in Summer 2019 to solicit Medicare-enrolled ambulance suppliers and providers.  In Fall 2019, to implement the triage lines for low-acuity 911 calls, CMS anticipates issuing a Notice of Funding Opportunity for a limited number of two-year cooperative agreements, available to local governments, their designees, or other entities that operate or have authority over one or more 911 dispatches in geographic locations where ambulance suppliers and providers have been selected to participate. 
For more information, please visit: https://innovation.cms.gov/initiatives/et3/.