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February 20, 2013

Realigning Reimbursement Policy and Financial Incentives to Support Patient-Centered Out-of-Hospital Care

Author Affiliations

Author Affiliations: Department of Emergency Medicine, Mount Sinai Medical Center, New York, New York (Dr Munjal); Department of Emergency Medicine and Epidemiology, The Center for Emergency Care Policy and Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, and Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services, Washington, DC (Dr Carr).

JAMA. 2013;309(7):667-668. doi:10.1001/jama.2012.211273

Innovative models of payment and care delivery are increasingly being used to expand access, improve quality, and reduce medical costs. Although traditional fee-for-service medicine favors doing more than is necessary, newer payment models aim to realign incentives to decrease utilization and increase efficiency. However, little consideration has been given to how fee-for-service reimbursement in out-of-hospital care limits the ability of emergency medical services (EMS) to provide more patient-centered care and reduce downstream health care costs.

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