EDs Getting Ready To Dive Into Value-based Payment Waters.

Area of Science:

• Healthcare Policy
• Emergency Medicine
• Patient Care Management

Background:

• The American College of Emergency Physicians advocates for a novel payment model.
• This model necessitates emergency department (ED) physicians monitoring patients for 30 days post-discharge.
• The Centers for Medicare & Medicaid Services (CMS) is considering adopting this model for Medicare.

Purpose of the Study:

• To inform emergency medical groups about an evolving payment structure.
• To highlight the importance of care coordination in new healthcare reimbursement models.
• To prepare stakeholders for potential changes in ED physician responsibilities.

Main Methods:

• Analysis of proposed payment model by the American College of Emergency Physicians.
• Evaluation of potential CMS adoption for Medicare beneficiaries.
• Assessment of care coordination requirements for participating emergency medical groups.

Main Results:

• A new payment model is being promoted, requiring extended patient tracking by ED physicians.
• CMS consideration of this model could impact Medicare reimbursement.
• Emergency medical groups face a learning curve regarding care coordination.

Conclusions:

• The proposed payment model signifies a shift towards prolonged physician accountability post-discharge.
• Successful implementation hinges on the capacity of emergency medical groups to master care coordination.
• Healthcare providers should proactively adapt to these prospective changes in patient management and reimbursement.