Over 5,100 Attend EMS World Expo 2014 in Nashville, TN

More than 5,100 people attended the 2014 EMS World Expo, held September 9–13 in Nashville, TN. It was the first time the conference, which is co-located with the National Association of EMTs Annual Meeting, had been back in the host city since 2002.

After two days of preconference workshops and the third annual World Trauma Symposium, the core conference program kicked off Tuesday, November 11, with a stirring tribute to longtime EMS educator Mike Smith, who passed away suddenly in October 2013, and a thought-provoking keynote presentation from Dr. Alexander Eastman on “Improving Survivability During Mass Shootings.”

Smith’s family spoke lovingly about his commitment to EMS education and the importance of early detection of heart disease in men before presenting the first Mike Smith Memorial Scholarship.

Eastman, MD, MPH, FACS, interim medical director for the trauma center at Parkland Memorial Hospital in Dallas, TX, and a lieutenant and deputy medical director (SWAT) for the Dallas Police Department, spoke about how there is no one-size-fits-all approach to mitigating an active shooter. But that’s where Tactical Combat Casualty Care (TCCC) comes in, as well as realizing the limitations of EMS and involving others in the community, especially in regard to hemorrhage control.

“This is not as complicated as many people think it is,” Eastman said. “This is a simple problem that needs to have simple solutions. Hemorrhage control is the responsibility of everybody in this room. We need to make sure we teach the public what to do. They’re the real first responders.”

Also during Tuesday’s opening ceremonies, the winners of the 2014 National EMS Awards of Excellence were recognized. See EMSWorld.com/12016199 to read about this year’s award recipients.
Exhibit Hall Offered Innovation, Education

The 2014 EMS World Expo offered the largest EMS exhibit hall in North America, with 328 exhibitors showcasing the latest products, technologies and services improving the delivery of patient care and enhancing the efficiency of EMS operations.

Attendees tested their clinical skills in the EMS World Expo Simulation Lab, where they worked through scenarios using the most advanced products and simulators available. Stations were manned by instructors who provided instant feedback on the performance of participants.

The Exhibit Hall Learning Center offered free CE for 30-minute quick-fire sessions taught by several members of the EMS World Expo faculty.

Mobile Integrated Healthcare Summit Focused on Contracts and Payment

A year ago, mobile integrated healthcare was still something EMS providers and the agencies they work for largely just talked about. At the second Mobile Integrated Healthcare (MIH) Summit, held in conjunction with EMS World Expo, it was increasingly apparent that the talk is shifting toward action.

MIH practitioners from across the United States gathered to discuss the ground-level challenges of implementing a community paramedic program; case management and patient assessment for mobile healthcare/community paramedics; MIH contracting; and the economic sustainability of EMS and MIH.

Among the questions asked of panelists 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 also need to decide how your EMS agency is going to get paid for the MIH services it provides.

Asbel Montes, vice president, government relations & reimbursement for Acadian Ambulance, said Acadian looked at using a capitated, or a per member per month model, based on a Monday–Friday, 8–5 schedule. Acadian is also seeking out 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 MedStar Mobile Healthcare in Fort Worth,  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 out patients are often willing to pay two to three times what it actually costs to provide the services.”

IH Forum Looked at New Ways of Delivering Patient Care

The day after the MIH Summit saw the debut of the Integrated Healthcare Forum.

Experts from the fast-growing field of integrated healthcare joined together to present information on education and training requirements across the spectrum of healthcare providers; pilot projects across the country; developing contracts with payers; and utilizing and implementing patient care data. Attendees learned how to conduct a community assessment to develop an integrated healthcare program in their area, and found out how integrated healthcare meets the Institute for Healthcare Improvement’s Triple Aim of better health, better healthcare and reduced costs.

Models of reimbursement were also discussed. EMS agencies are going to have to work with their partners in the healthcare system to get them to understand the benefits of this new way of offering care. Part of that education process is getting payers to see the value in paying EMS to keep patients out of the hospital, such as is already happening with CHF patients in some programs. One thing panelists emphasized was the need to retain all rights to data when contracting with different payers and health systems. It sounds minor, but that data is what the agency is going to use to sell itself to other customers as its mobile integrated health program grows.