Vo l u m e X X X , N o . 4 J u l y 2 016
The Medicare Quality Payment Program What physicians need to know By Lisa Gall, DNP, FNP, and Candy Hanson, BSN, PHN
T Emergency Medical Services Regulating an evolving profession By Tony Spector, MA, JD
F
or some, the term Emergency Medical Services (EMS) evokes memories of paramedics Johnny Gage and Roy DeSoto from the venerable (and industry-defining) television series “Emergency!” For others, it reminds them of early childhood in Greater Minnesota and a ride to the hospital in a hearse that doubled as the community ambulance. For me, I recall the many medical and trauma calls I responded to as a police officer and deputy sheriff. Whether viewed as part of health care, public safety, or transportation,
EMS arguably is in its infancy; it is an industry that began in the 1960s and has endeavored to evolve into a profession. To aid in its evolution, the state of Minnesota formed the executive branch regulatory agency known as the Emergency Medical Services Regulatory Board (EMSRB) in 1996. The mission of the EMSRB is to protect the public’s health and safety through regulation and support of the EMS system. We are the lead agency in Minnesota responsible for Emergency Medical Services to page 10
he past five years has heralded significant changes in health care delivery with increased provider accountability to use health information technology to document care, report quality and costs of care, and exchange health information with patients and other providers. All of these complex changes are needed to shift health care to a focus on high-quality care at a cost that’s sustainable. The Centers for Medicare & Medicaid Services (CMS) implemented several incentive programs to drive these changes: 1) the Electronic Health Records (EHR) Incentive Program requires the “meaningful use” of certified EHRs; 2) the Physician Quality Reporting System (PQRS) requires eligible providers to report additional quality measures, and 3) the Value-Based Payment Modifier (VBM) Program adjusts Medicare payments based on the cost and quality of services provided. Each program has a different mix of eligible providers and clinicians and reporting requirements have not The Medicare Quality Payment Program to page 12