Highmark to pay ambulance companies for treating patients outside hospital

Highmark and Allegheny Health Network, both in Pittsburgh, launched a pilot program under which Highmark will reimburse ambulance companies for some calls where patients are not taken to a hospital, according to Trib Live.

Under the new "treat-and-release" program, which the organizations announced Aug. 29, Highmark will contract with 16 emergency medical services. The health insurer will reimburse the companies for treating adult patients with seizure disorders, low blood sugar and asthma attacks outside the hospital. This bypasses a requirement that ambulance companies only receive payment when a patient is taken to an emergency department.

Highmark did not disclose how much it will pay the ambulance companies for each call, according to the report.

After patients are treated and assessed on-scene under emergency medicine physician supervision, Allegheny Health Network staff will call the patient within 48 hours to check in on his or her condition.

"The goal of the pilot is to reduce unnecessary emergency department visits and improve the overall patient experience, decrease healthcare costs and ensure that ambulance services are paid fairly and members receive appropriate care," Highmark said in a news release obtained by Trib Live.

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