Abstract
IntroductionThis comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes.MethodsWe conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal law pertaining to EMS.ResultsMany changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems. New Medicaid enrollees and changes to existing coverage plans may alter EMS transport volumes. Reimbursement changes such as adjustments to the ambulance inflation factor (AIF) alter the yearly increases in EMS reimbursement by incorporating the multifactor productivity value into yearly reimbursement adjustments. New initiatives, funded by the Center for Medicare & Medicaid Innovation are exploring novel and cost-effective prehospital care delivery opportunities while EMS agencies individually explore partnerships with healthcare systems.ConclusionEMS systems should be aware of the direct and indirect impact of ACA on prehospital care due to the potential for changes in financial reimbursement, acuity and volume changes, and ongoing new care delivery initiatives.
Highlights
This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes
In the wake of the current healthcare reforms initiated in the U.S by the ACA, potential changes to EMS are largely side effects of inpatient and emergency departments (ED) changes
EMS and emergency care is directly addressed by the ACA, changes to transport destinations and operations remain unchanged
Summary
This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes. Areas of change in emergency medicine identified by a prior review included a greater proportion of Medicaid-insured patients, changes in patient volume, and variable increases in acuity.[6] these changes are directly studied in relation to patients presenting to the ED, EMS agencies have already begun to implement and propose adaptations that respond to these observed changes.[7,8,9] This comprehensive review synthesizes the existing literature regarding ACA-related changes in emergency care that impact EMS systems and specific measures within the ACA that have the potential to directly impact EMS systems
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