Physician Medical Director Compensation on EMS Quality & Standards of Care

The National Association of EMS Physicians (NAEMSP) supports the modernization of emergency medical services (EMS) and realignment of incentives to advance medical excellence in the provision of patient care to emergency medical patients in the out-of-hospital setting.   Physician medical directors form the essential foundation of quality and excellence in EMS patient care as they directly or indirectly supervise all of EMS care for many cities and counties across the nation.  However, in the current EMS system physician medical directors are not compensated for this additional work unless operating in very specific circumstances or within certain facilities at the time of engagement, removing a compensatory component to what is a significant and important part of their job.

As EMS has matured over the past half century, we’ve made much progress in our delivery of quality and safe medical care.  For instance, CMS and CMMI took strides in piloting the ET3 program — a new EMS care delivery model to provide patient centered care, increase efficiency in the EMS system and encourage appropriate utilization of EMS.  New proposals initiated during the pandemic have introduced mechanisms to potentially amend and update the current EMS system into a modernized one that utilizes treatment-in-place and other scenarios outside of the traditional treatment and transport to a hospital.  NAEMSP supports modernizing the model of care to include treatment in place and transport to alternate destinations.  However, these and any changes must be coupled with meaningful and measurable patient safeguards to ensure quality and safety of patient care and appropriate medical decision-making for patient treatment and disposition. 

NAEMSP Advocacy:‎

  • Richard Hudson has committed to securing the initiation of a MedPAC to help collect necessary information that will help inform a future EMS system where EMS medical directors are appropriately compensated for the important oversight work they perform while also setting the stage for the establishment of Conditions of Participation (COPs) as a requisite for participation in the Medicare program to ensure patient safety as seen in other forms of medicine. Rep. Hudson is awaiting a bill draft from legislative counsel in order to introduce. 
  • NAEMSP is advocating for inclusion of meaningful medical direction and patient safeguards in any legislation that would allow for treatment in place and transport to alternate destinations.
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