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Downloads Pre-Arrival Instructions to the CHM Which Provides Them to Joe’ Wife Table of Contents Testimonials for the MIH Handbook ...................................................................................................4 Thanks to our Contributors ................................................................................................................4 Chief Les Caid ........................................................................................................................................ 4 Chief Jeff Clark....................................................................................................................................... 4 Chief Danny Kistner ............................................................................................................................... 5 Chief Steve Koering ............................................................................................................................... 5 Chief Pete Lawrence ............................................................................................................................. 5 Chief Deputy Mike Metro ..................................................................................................................... 5 Chief Porter Welch ................................................................................................................................ 5 Mike Ragone ......................................................................................................................................... 6 Chief Mitch Snyder ................................................................................................................................ 6 Chief Tim Whitham ............................................................................................................................... 6 Executive Summary ............................................................................................................................7 Section I: Why Is MIH Important? .......................................................................................................9 Chapter One: How Changes in Healthcare are Driving Change in Medicine and EMS .........................9 Healthcare in America ........................................................................................................................... 9 Chapter Two: Setting the Stage for Change ................................................................................... 11 What Do Fire and EMS Leaders Need to Know ................................................................................... 11 Those with Public Health Insurance Are Higher Users of Emergency Rooms .................................... 11 Does Having More People with Health Insurance Result in Higher Reimbursements? ..................... 12 Who Will Pay our EMS Billings in the Future? .................................................................................... 12 Centers for Medicare and Medicaid Services ..................................................................................... 13 Value-Based Purchasing ...................................................................................................................... 13 The Federally Funded EMS Compass Project ...................................................................................... 14 Develop the Right Mindset ................................................................................................................. 14 What Happens if the PPACA is Dismantled or Changed because of the New Administration? ......... 15 Chapter Three: Ambulance Transport Reimbursement Changes ..................................................... 16 Chapter Four: Fire Department Relevancy ..................................................................................... 19 Chapter Five: Improving Organizational Efficiencies ...................................................................... 21 Organizational Delivery System Reform ............................................................................................. 21 Redefining Response Policies .............................................................................................................. 22 Leveraging Fire Department Infrastructure ........................................................................................ 22 Conclusion ........................................................................................................................................... 23 Section II: Should I Consider MIH for My Department? ...................................................................... 24 1 Chapter Six: Is MIH Right for You? Eight Questions to Determine if MIH Could Benefit Your Organization. ............................................................................................................................... 24 A Familiar Story: Paramedics in the 1970s.......................................................................................... 24 The Playing Field Has Changed ........................................................................................................... 24 Three Types of MIH Departments. ...................................................................................................... 25 Eight Questions to Ask to Determine if MIH is Right for Your Department ....................................... 25 The Seemingly Elusive MIH Reimbursement Stream .......................................................................... 28 Summary ............................................................................................................................................. 29 Chapter Seven: MIH and the Volunteer or Combination Department ............................................. 30 Case Study ........................................................................................................................................... 30 Are you making a difference? ............................................................................................................. 32 A History of Adaptability ..................................................................................................................... 32 Section III: Develop Financial Sustainability for MIH Programs and Identify Organizational Benefits ... 33 Chapter Eight: Developing Financial Sustainability ........................................................................ 33 1. Design a system with the types of personnel that can bill for services per your state’s healthcare billing rules. ......................................................................................................................................... 33 2. Target a UHU rate that will at least pay for the costs of the MIH unit. .......................................... 33 3. Establish a billing methodology and fee structure that achieves financial sustainability and provides value to the existing payers of ambulance transports and emergency room interventions. ............................................................................................................................................................ 34 4. Calculate the MIH program costs. ................................................................................................... 34 5. Calculate the value you bring to your payers. ................................................................................ 35 6. Calculate the financial impact if you are a transport entity. .......................................................... 36 Chapter Nine: Identifying the Organizational Benefits of an MIH Program ..................................... 37 Organizational Efficiencies .................................................................................................................. 37 Reimbursement................................................................................................................................... 38 Cost Avoidance .................................................................................................................................... 38 Chapter Ten: Integration and Finance ........................................................................................... 40 EMS Needs to Integrate into the Overall Healthcare System ............................................................. 40 EMS Finance: The Existing Reimbursement Stream ........................................................................... 40 Transports versus Nontransports ....................................................................................................... 43 Section IV: Step by Step to Developing an MIH Program .................................................................... 45 Chapter Eleven: Steps to Implement an MIH Program ................................................................... 45 Step One: Is MIH Right for Your Department? ................................................................................... 45 Step Two: Identify and analyze your MIH population pools. .............................................................. 46 Step Three: Determine the type of medical personnel needed to staff an MIH unit. ........................ 47 2 Step Four: Identify those entities that will benefit and those that will be impacted by your MIH program as well as stakeholders. ........................................................................................................ 47 Step Five: Determine the costs to implement and maintain an MIH
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