Potential Impacts - EMS Systems Shrinking Patient Care Revenues Number of Medi-Cal transports grows with more patients covered by lowest source of reimb Loss of cost shift to commercial insurers Continued shifts in payer mix; potential second wave of uninsured as businesses drop coverage New CMS-approved access to care standard allows further Medi-Cal rate reductions Near universal coverage guarantees many still uninsured (1-2 million) New pressures associated with county responsibility for indigent care; county rate regulation Broader Reforms Eventually Reach EMS New health information technology requirements Value-based purchasing (or pay-for-performance) eventually applies to EMS Comparative effectiveness research impacts system design Too early to know impacts of ACOs and shared savings programs Potential Need for EMS System Redesign Triple Aim: Better health, better quality, lower cost Community paramedic programs grow EMS becomes more integrated with the rest of health care
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