As hospital capacity shrinks and cases surge, the need to update Maryland’s outdated and inefficient EMS system is becoming more urgent.
Since being discovered in November, the Omicron variant of COVID-19 has drastically changed the situation on the ground. Hospitals are now nearing capacity, and just yesterday, the state reported the most significant single-day rise in Covid cases.
In a move to combat this recent wave, Governor Hogan tapped into $100 million in emergency funding to shore up staff shortages at medical facilities and nursing homes. However, it is becoming more apparent that an adequate response to the pandemic involves more than just financial resources. This latest surge underlines the urgent need to change how we respond to medical emergencies.
For the 2022 legislative session, MACo is prioritizing updating Maryland’s Emergency Medical Service (EMS) funding and service delivery system. EMS reform will immediately impact how we respond to and manage this pandemic.
Critical Areas to Reform:
Transport to facilities other than an Emergency Room.
It is not always appropriate to transport patients to an Emergency Room (ER) to receive care. And, as hospitals statewide are reporting that they are nearing capacity, it is critical to relieve pressure on overwhelmed parts of our medical infrastructure. As such, EMS must be able to transport to alternative healthcare providers when appropriate (i.e., urgent care, treatment facilities, etc.)
Mobile Integrated Health (MIH)
There are times that treatment in the field is more appropriate than transport to a medical facility. Covid’s easy transmissibility in concentrated groups has highlighted the need to provide medical care in less dense settings. Providing care in the field avoids unnecessary contact, lessening the virus’s chances of spreading.
Billing and Funding
The current EMS funding model neglects to reflect the importance of the service. Over two decades ago, the general assembly set a $100 billing limit for transport to a licensed facility (i.e., an ER). Since the last round of reforms, the cost of transportation and the services provided have grown exponentially. The past two years alone have highlighted the critical need for an adequately funded EMS system.
The cap on billing needs to be raised gradually from the current $100 to $300. In addition, providers must have the authority to bill for more than just transport, as they provide other services in the field and while in transit to a facility. Not allowing for both an increase in the cap and an expansion of billable services leaves EMS in a dangerous financial position.
We are entering the third year of the pandemic. Until global vaccination rates increase, we will likely experience future variants and surges. Reforming EMS will relieve pressure on our medical infrastructure during moments of crisis, such as this pandemic.
Relieving stress on hospital capacity is an achievable goal. Reducing spread in medical settings by providing in-field care or transport to other facilities is an achievable goal. Having an EMS system ready for the next surge is an achievable goal. Bottom line, we need to act now to shore up our EMS system; it is no longer a question of if there will be another surge, but when.