The coronavirus pandemic continues to surge, straining healthcare systems in Louisiana and around the country. Emergency ambulance crews are delivering patients to hospitals and emergency departments that are at, or very near, capacity.  

A new EMS delivery model is relieving some of the strain on hospitals, while helping low-acuity patients receive the care they need in a faster, more efficient, and more convenient manner.

Acadian Ambulance has been working with federal, state, and local officials and healthcare providers to offer alternatives for patient care when a trip to the hospital may not be necessary. The new models, known as Treatment in Place or Alternative Destination Transport, allow EMS crews to offer solutions that best meet patients’ needs. If the patient’s condition warrants emergency department care or the patient prefers to go to the hospital, crews will continue to make that transport.

Acadian Ambulance Chief Medical Officer Dr. Chuck Burnell believes this is a giant step forward in providing the most appropriate care to the patient. “We know that many 911 callers can be cared for in their homes or at the scene of an emergency,” he said. “Our paramedics and EMTs consult with a physician via telehealth, provide the necessary care and then help arrange follow-up appointments with a primary care provider. Other patients may need to see a provider, but not necessarily require an ED visit. They are better served in an urgent care or physician’s clinic, or a behavioral health facility.”

The federal Centers for Medicare and Medicaid Services (CMS) announced a pilot program known as Emergency Triage, Treat and Transport (ET3) in late 2019. While in the planning stages, the program was delayed when the pandemic struck. However, as healthcare providers were suddenly forced to consider all available options to help ease hospital overcrowding, Treatment in Place and Alternative Destination Transports became logical solutions.

Since June 2020, these programs have been available to residents of Louisiana under an emergency measure of the declared Public Health Emergency. CMS recently announced that ET3, which will provide Medicare patients with coverage for Treatment in Place and Alternative Destination Transports, is back on schedule. Acadian Ambulance was one of 205 agencies nationwide selected for the pilot program and will begin participating in February 2021.

“We’ve been working with federal and state officials for some time on this innovative delivery model, but the pandemic really moved it into high gear,” Acadian Ambulance President Justin Back said. “We are also working to support patient and provider engagement during this time and have been receiving calls from primary care providers to facilitate telehealth visits with their patients in crisis. I think much of the success is due to a high level of physician involvement and, of course, the great work of our highly trained and dedicated medics. We’re proud that our professionals in the field have embraced this new program and the flexibility to do what is in the best interests of our patients.”

Approved by the Louisiana Department of Health, Acadian Ambulance has also been partnering with the state’s Medicaid and commercial insurance companies to provide this innovative service during the coronavirus pandemic. Since June 2020, approximately 200 patients each month have opted to receive Treatment in Place or Alternative Destination Transport following a live telehealth consultation with a physician, relieving pressure on local hospitals.   

The Treatment in Place and Alternative Destination Transport program has been adapted by all five Medicaid programs, giving approximately 1.4 million Louisianans new options for patient care. Commercial insurance providers are also signing up to enable their members to participate. 

Acadian Health Manager Richard Belle said, “The Treatment in Place and Alternative Destination Transport program is a patient-centered approach that aligns with the Institute for Healthcare Improvement’s Triple Aim Initiative, which was designed to improve the patient experience of care, including quality and satisfaction, improve the overall health of the population and reduce the cost of healthcare. Ultimately, it can reduce costs to the patient, who is most important in this process.” 

Acadian Ambulance Chairman & CEO Richard E. Zuschlag said, “Acadian Ambulance has been, and always will be, a leader in mobile healthcare. Quality and innovation are part of our core values. We continue to invest in growth and innovation to ensure Acadian Ambulance is an industry leader in the next generation of EMS. By continuing to develop meaningful partnerships with health plans, health systems and providers, we will continue to be a national leader in mobile healthcare, treating patients in the safety and comfort of their homes.”


Originally published January 27, 2021

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