Changes expected to help some struggling EMS agencies become more efficient

MORGANTOWN, West Virginia. — Two state-level changes to emergency medical services agencies are intended to improve care and expand reimbursement opportunities for local units.

Forest Weyen, director of Mon EMS, said the two parts of Senate Bill 533 allow some patients to be treated on-site and another part provides for patients to be transferred to an alternative destination, such as a doctor’s office or emergency room.

“There is no silver bullet to solve the coverage issues, the preparedness costs and the reimbursement costs,” Weyen said. “As you see in the headlines every day, there are EMS agencies struggling and closing all over the state.”

Starting May 1, patients can now be treated where they are using telemedicine. Patients can connect virtually from home, a nursing home or a clinic to receive the treatment they need. Weyen said the new process will keep intensive care aisles open at hospitals across the state.

“The data says you do better at home,” Weyen said. “If we can keep you out of the hospital and keep non-emergency patients from going to the hospital and take up a valuable bed in the emergency department for the supercritical patients, that’s better for the overall health of the patient.”

The list of ailments is limited, Weyen said, but the new law makes insurance reimbursement mandatory. For some agencies, Weyen said, that could allow units to collect up to 30 percent more in billed revenue.

“Leave those patients at home or wherever they are if they don’t want to go to the hospital,” Weyen said. “The beauty of that for EMS agencies is that this law makes it mandatory that insurance pay for that.”

Another change in Senate Bill 533 allows for patients to be transported to alternative treatment facilities. This will help connect patients to the right care option in a more timely manner.

“After January 1, 2025, that may change,” Weyen said. “We’ll be able to take patients to places like urgent care centers, primary care offices, behavioral health centers, specialty facilities, those types of places.”

Weyen used the example of someone with a fever or runny nose that has been going on for several days. Under the current system, they would be taken to the highest level of care for evaluation before being moved to the appropriate level of care or institution.

“Patients who need the most care are taken to the right place, and we keep valuable emergency room beds free in case of severe chest pain or a car accident, making the system run more smoothly,” Weyen said.