A new model for healthcare reimbursement?

We’ve heard it for several years now: Value-based purchasing is coming.

But some of you, I know, are beginning to wonder if that future will ever arrive. After years of hearing about these changes, we still largely get reimbursed the same way we have for decades.

A recent report out of Maryland shows that the value train keeps on chugging along, though. And while it may take a while to reach EMS, the impact it’s having on healthcare suggests that it will only accelerate further. In Maryland, the state received a waiver from CMS a few years ago that allows them to pay hospitals on a per capita basis—meaning hospitals know at the beginning of the year what their revenue will be. The idea was to encourage healthcare systems to keep people healthy and out of the hospital. Three years after Maryland started essentially paying hospitals to lower admissions, savings added up to an estimated $538 million, exceeding its five-year benchmark of $330 million, a new report shows.
Three years after Maryland started essentially paying hospitals to lower admissions, savings added up to an estimated $538 million, exceeding its five-year benchmark of $330 million.
“Like a giant health maintenance organization, the state caps hospitals’ revenue each year, letting them keep the difference if they reduce inpatient and outpatient treatment while maintaining care quality,” wrote Kaiser Health News’ Jay Hancock. “Such ‘global budgets,’ which have attracted rare, bipartisan support during a time of rancor over health care, are supposed to make hospitals work harder to keep patients healthy outside their walls.”

Although the report doesn’t touch on EMS specifically, you’ll see vast opportunity for our profession. If the future of healthcare lies in finding ways to keep patients healthy and at home, EMS can play a significant role in getting us there.

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Best Regards,


Jay Fitch, PhD
Founding Partner, Fitch & Associates