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Review
. 2017 Apr;18(3):446-453.
doi: 10.5811/westjem.2017.1.32997. Epub 2017 Mar 13.

Areas of Potential Impact of the Patient Protection and Affordable Care Act on EMS: A Synthesis of the Literature

Daniel G Ostermayer  1   2 , Charles A Brown  3 , William G Fernandez  1 , Emily Couvillon  4
Affiliations
Review

Areas of Potential Impact of the Patient Protection and Affordable Care Act on EMS: A Synthesis of the Literature

Daniel G Ostermayer et al. West J Emerg Med. 2017 Apr.

Abstract

Introduction: 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.

Methods: We 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.

Results: Many 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.

Conclusion: EMS 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.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Figures

Figure 1
Figure 1
PRISMA flowchart of systematic literature review of changes to emergency care related to the Affordable Care Act that directly affect emergency medical services.
Figure 2
Figure 2
Ambulance fee schedule reimbursement calculation. AIF, ambulance inflation factor.
See this image and copyright information in PMC

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References

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