Changes Looming for EMS - EMS Insider - @

Making the Most of Health-Care Reform

Pinnacle keynote speaker urges providers to seize opportunities ahead



Jennifer Doyle | | Tuesday, August 10, 2010

Ed Racht, MD, told attendees at this year's Pinnacle conference in San Diego that health care and EMS are rapidly evolving. "The way we look a year from now is going to be dramatically different," Racht warned during his July 27 keynote address titled "The Looming Realities of Healthcare Reform for EMS."

Racht—who was named Chief Medical Officer for American Medical Response on July 26 and most recently served as the vice president of Medical Affairs and Chief Medical Officer for Piedmont Newnan Hospital in metro Atlanta—noted that health-care reform is really "payment reform that has huge health-care implications." EMS, he said, is only mentioned a total of four times in the 2,400-page behemoth bill, but there’s no doubt prehospital medicine will change along with everything else in health care.

"We're on the edge of another major change in EMS culture," Racht says. "Whether you buy into that or not, it's here." He believes there are many opportunities for EMS to define its role in the larger system, helping to cut costs while improving patient safety and outcomes through better-coordinated care. "The current system is based on the quantity of the care provided, with minimal focus on quality or coordination." Those days are coming to an end, Racht says.

Racht provided a timeline of the Patient Protection and Affordable Care Act implementation between now and 2018, noting that the bill's call for comparative effectiveness research shouldn't be taken lightly. "The things that make a difference in patient outcomes, we ought to be reporting," because sooner rather than later the government is going to "see how you do to decide if you deserve payment," Racht says, meaning Centers for Medicare & Medicaid Services (CMS) reimbursements will eventually be based on the quality of care provided, not the quantity.

New Opportunities for EMS
"What's coming next is going to be hard work," Racht says, but "our opportunities await."

One aim of the health-care reform legislation is to create Accountable Care Organizations (ACOs), he says. An ACO could be a hospital or group of physicians and ancillary health-care providers—labs, therapists, etc.—that coordinate medical care for a specific patient population. The health-care reform legislation says Health and Human Services will establish a program that supports ACOs for fee-for-service Medicare patients by Jan. 1, 2012. Under such a system, "hospitals will need to work with other health-care providers to avoid readmissions," because "soon they will not be compensated," according to Racht.

"Could there be a way that hospitals and EMS could collaborate? Yes," says Racht. "Can you imagine a post-hospital EMS role? Absolutely." The biggest challenge in realizing these opportunities is getting all the "adversaries" together, he says. "That's not been a natural process," but EMS agencies need to start asking questions and working with hospitals and others in the larger health-care system to develop potential solutions.

Other opportunities could include an EMS role in alleviating emergency department overcrowding through better triage, treat-and-release programs, transport to alternate destinations or even assisting in some way with managing patient flow in the emergency departments.

Payment reform is here; how that will play out isn't yet clear, but we have an "opportunity to play a totally different role in the EMS system." The key, Racht says, is ensuring someone else doesn't define that role.
Racht closed his speech, urging audience members to make the most out of the new legislation, with a quote by Sir Francis Bacon: "Wise men make more opportunities than they find."

Related Links:

Connect: Have a thought or feedback about this? Add your comment now
Related Topics: EMS Insider, Leadership and Professionalism, Pinnacle, Ed Racht, American Medical Response


Jennifer Doyleis the editor of EMS Insider. She has written and edited for the JEMS family of publications for 10 years. Contact her at


What's Your Take? Comment Now ...

Buyer's Guide Featured Companies

Featured Careers & Jobs in EMS

Get JEMS in Your Inbox


Fire EMS Blogs

Blogger Browser

Today's Featured Posts


EMS Airway Clinic

Innovation & Advancement

This is the seventh year of the EMS 10 Innovators in EMS program, jointly sponsored by Physio-Control and JEMS.
More >

Multimedia Thumb

Glendale Firefighters Suspended for Punching Patient

Excessive force was used on a combative patient.
Watch It >

Multimedia Thumb

Vancouver Chemical Fire Causes Major Response

Hazmat incident sends smoke over port neighborhood.
Watch It >

Multimedia Thumb

Salt Lake City Firefighters Injured in Firehouse Fire

Nine sent to a hospital with smoke inhalation.
Watch It >

Multimedia Thumb

Pennsylvania Paramedic Killed in the Line of Duty

West End Ambulance medic killed at accident scene.
Watch It >

Multimedia Thumb

Plane Skids off Runway at LaGuardia Airport

Delta flight stops just short of Flushing Bay
More >

Multimedia Thumb

Rigs Going in Service from EMS Today 2015

Snap shots of some of the vehicles at EMS Today that will be on the streets soon
More >

Multimedia Thumb

LMA MAD Nasal™

Needle-free intranasal drug delivery.
Watch It >

Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >

Multimedia Thumb

Field Bridge Xpress ePCR on iPad, Android, Kindle Fire

Sneak peek of customizable run forms & more.
Watch It >

Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >

More Product Videos >