MORGANTOWN, W.Va. — Two changes at the state level for Emergency Medical Services agencies are intended to improve care and increase reimbursement opportunities for local units.
Mon EMS Executive Director Forest Weyen, said the two portions of Senate Bill 533 allow some patients to be treated in place and another provides for patients to be taken to an alternate destination like a doctor’s office or urgent care facility.
“There’s not a silver bullet to solve the coverage problems, readiness costs, and reimbursement costs,” Weyen said. “As you see in the headlines every day, there are EMS agencies that are struggling and closing across the state.”
As of May 1, patients can now be treated where they are using telemedicine. Patients can connect virtually from home, a nursing home, or a clinic to receive the treatment they need. Weyen said the new procedure keeps critical care pathways open at hospitals across the state.
“The data says you progress better at home,” Weyen said. “If we can keep you out of the hospital and keep non-emergent patients from going to the hospital and taking a valuable emergency department bed for the super-critical patients, that’s better for overall patient health.”
The list of ailments is limited, according to Weyen, but the new law makes insurance reimbursement mandatory. For some agencies, Weyen said that could allow units to collect up to 30 percent more in billed revenue.
“Leave those patients at home or wherever they’re at if they don’t want to go to the hospital,” Weyen said. “The nice part about that for EMS agencies is that this law makes it mandatory that insurance reimburses for that.”
Another change in Senate Bill 533 allows patients to be transported to alternate treatment facilities. This will help pair the patient with the correct care option in a more timely fashion.
“After January 1, 2025, that can change,” Weyen said. “We will have the ability to take patients to places like urgent care centers, primary care physician offices, behavioral health, specialty facilities, and those types of places.”
Weyen used the example of someone with a fever or sniffles that’s continued for several days. Under the current system, they would be taken to the highest level of care for evaluation before being moved to the appropriate level of care or facility.
“Patients that need the most care are taken to the right place, and we leave valuable emergency department beds open, ready for massive chest pain or a car accident, which makes the system run more smoothly,” Weyen said.