Peeling Back the Layers of the Cost Data Collection Instrument…
Section 5: Service Volume
Part Two
We continue our series of blog posts to dissect the Cost Data Reporting mandate and the online reporting instrument that CMS will use to collect the data.
Our last blog post, focused on Section 4: Emergency Response Time Reporting. This post will look at the area used to report ground ambulance service volumes. We have chosen to focus this part as one of the select areas we anticipate will generate the most questions and cause respondents to stress more than others when submitting data.
Four Data Elements
Section 5 of the Cost Data Reporting instrument will prompt the user to report numbers across four different areas. Ground ambulance providers and suppliers will be asked to report these numbers…
- Total Responses
- Ground Ambulance Responses (only)
- Ground Ambulance Responses NOT resulting in a transport
- Paid Ground Ambulance Transports
Let’s take a look at each element.
Total Responses
As you prepare the information you will be reporting throughout the one-year reporting period you have been requested to report on, by compiling your total number of responses. This number will be equal to the sum of all responses by any and all vehicles that comprise your agency.
This means that if you are a fire-based service, for example, you will report the total number of responses including fire, rescue, QRS, etc. This number, for this particular element, is NOT limited to simply ground ambulance responses. The number you report will be a total of all responses, regardless of the type of response.
Ground Ambulance Responses (only)
Next, you will be asked to report the number of ground ambulance responses. Obviously, this number will only be the number of runs that you responded to in whatever vehicle is defined by your state, regional or local protocol as a ground ambulance (CMS also has alerted that, globally, water ambulances will count as ground ambulance vehicles for this project, but NOT air ambulances.)
If your agency is strictly an EMS agency and you only use ground ambulance vehicles to respond, then it is possible that your answer to this question will be equal to the answer you provided for total responses. If you are not exclusively using ground ambulance vehicles for all responses, then you will be reporting a value in this section that is less than the number you provided for the total responses question.
Ground Ambulance Responses NOT Resulting in a Transport
In this area, respondents will break out and report a number that is equal to the number of times over the one-year reporting period that your ground ambulance vehicles responded but the end result did not include the transport of a patient for those responses.
The guidance offered by CMS is that this number can be equal to your response to the previous question (Ground Ambulance Responses) but most likely will be less than (but never more than that number!) Obviously, this will help CMS gain a feel for how many times your agency responds and encounters patient refusals, cancellations, no-patient-found scenarios, cancelled by another first-responder agency prior to arrival, etc.
Please allow us to insert here that we believe that this particular section is very important to the mission of this exercise, so it is VERY important that you accurately report on this number. The critical takeaway from answering this question will demonstrate to CMS and ultimately to Congress, the many times we respond that does not result in any potential for reimbursement. These responses cause us to be very inefficient, as there is a cost associated with each response whether or not we perform an actual hands-on patient care function. This section will hopefully call their collection attention to the fact that we must maintain constant readiness to respond at great cost to our agencies with no incoming monetary offset to pay for those costs over the majority of these scenarios.
Paid Ground Ambulance Transports
The final “ask” for this section will be a question that requires respondents to provide a number that represents ground ambulance transports for which your agency receives a payment from some payer source following the completion of the response.
When you are preparing your answers, you will be compiling the number of individual ground ambulance responses that produced some kind of payment for your organization. Of course, CMS will not allow you to report a numeric value in this space that exceeds the answer to the ground ambulance responses question. This number must be equal to or less than the number that you reported in that preceding section.
With that said, we would find it very surprising if anyone is able to lay claim to all ground ambulance transports resulting in a payment, and therefore the answer to this question will most likely always be a value that is less than reported in the Ground Ambulance Responses subsection.
