Areas of Potential Impact of the Patient Protection and Affordable Care Act on EMS: A Synthesis of the Literature

This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act’s (ACA) as it relates to Emergency Medical Services (EMS) in order to provide guidance for navigating current and future healthcare changes. Patient usage and access to care, healthcare quality assessments, reimbursement changes, new EMS innovations, and changes to emergency preparedness are the major areas impacted by the ACA. Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems. New Medicaid enrollees and changes to existing coverage plans may alter EMS transport volumes. Reimbursement changes such as adjustments to the Ambulance Inflation Factor (AIF) alter the yearly increases in EMS reimbursement by incorporating the multifactor productivity value into yearly reimbursement adjustments. New initiatives, funded by the Center for Medicare & Medicaid Innovation (CMMI) are exploring novel and cost effective prehospital care delivery opportunities while EMS agencies individually explore partnerships with healthcare systems