Mobile Integrated Healthcare Summit: How to Get Paid

Mobile Integrated H’care Summit: How to Get Paid

During the second Mobile Integrated Healthcare Summit, held in conjunction with EMS World Expo on Nov. 12, experts from across the United States gathered to discuss the ground-level challenges of implementing community paramedic programs; case management and patient assessment for mobile healthcare/CPs; MIH contracting; and economic sustainability.

Among the questions was how MIH contracts differ from traditional ambulance contracts. For starters, you have to get payers used to paramedics doing different things than just transport. Then you need to decide how your EMS agency is going to get paid for the MIH services it provides.

Asbel Montes, vice president of government relations and reimbursement for Acadian Ambulance, said Acadian looked at using a capitated model based on a Monday–Friday, 8–5 schedule. Acadian is also seeking outgoing managed-care individuals and has moved to a fee-for-service model with pediatric asthma patients. 

“As you’re working through contract negotiations and management, you have to be very fluid and see what works for your customer,” Montes advised. “There are no one-size-fits-all models, but you also have to remember you can’t do it for free.”

Matt Zavadsky, public affairs director at Texas’ MedStar Mobile Healthcare, said MedStar started with a similar fee per patient contact per hour model, but has since switched to enrollment fees for the patients it sees as part of its MIH program. “Whatever price you think you want to charge for this, ask for at least twice that amount,” Zavadsky stated bluntly. “We’ve found patients are often willing to pay 2–3 times what it actually costs to provide the services.”

The biggest takeaway from the day’s sessions was that EMS/MIH agencies ultimately need to build their programs in a way that works specifically for their agency and service area. 

For more see www.emsworld.com/article/12020855.

—Jason Busch

Medtronic Unveils MIH Resource Center

A new publication from Medtronic Philanthropy, Principles for Establishing a Mobile Integrated Healthcare Practice, highlights the debut of the company’s new MIHP Resource Center, https://mihpresources.com/.

The guide overviews the key tenets underlying MIH practices, focusing on areas like assessing population health needs; competencies and education; clinical leadership/medical oversight; financial, legal and political considerations; and program evaluation. Its contributors include IHD’s three founding physicians, Eric Beck, DO; Jeff Beeson, DO; and Brent Myers, MD.

The website will provide resources, articles, case studies and other information.

Readmission Penalties Reach New High

A record 2,610 hospitals were fined for having too many preventable readmissions in the latest round of Medicare penalties. That’s three-quarters of those subject to the Hospital Readmissions Reduction Program.

While the readmission rate is falling nationally, Medicare’s average fines are increasing, and 39 hospitals were assessed the largest penalty allowed. Last year almost 18% of Medicare patients who had been hospitalized were readmitted within 30 days. For around 2 million patients a year, that totals $26 billion in costs—$17 billion of it preventable.

One of the reasons is that Medicare added two new categories of patient—those with lung ailments such as chronic bronchitis and those getting knee/hip replacements—to its original three for which readmissions would be tracked.