Emergency Triage, Treat and Transport (ET3)

What is ET3?

Emergency Triage, Treat and Transport (also known as ET3) is a voluntary, five-year, CMS Innovation Center payment model designed to reduce unnecessary transport to emergency departments. The CMS Innovation Center released a Request for Applications (RFA) in early August 2019 for ambulance providers and suppliers who wish to participate in ET3 when serving Medicare Fee-for-Service (FFS) members. Applications were due Oct. 5, 2019.

CMS and AHCCCS recognize that the long-term sustainability of the ET3 model program will depend upon the participation of multiple payer sources. Accordingly, the Request for Applications (RFA) gives preference to providers who have partnered with multiple payer sources, including their State Medicaid Program, as this increases the likelihood of creating a long term, sustainable, ET3 program.

Applicants for the RFA were encouraged to submit Letters of Intent (LOI) for these additional payer sources. AHCCCS explored participating in the ET3 model. To provide support to our EMS providers, AHCCCS issued a Letter of Intent for their use in the RFA.

AHCCCS Letter of Intent for the ET3 Program

Interested providers are encouraged to subscribe to ET3 email alerts. Please fill out the contact information in the form and select “ET3 Updates” under the “Email Lists” section. You may unsubscribe at any time by clicking the “unsubscribe” link at the bottom of every email. For questions about the agency’s ET3 implementation plans, please contact Alexa Kaumaya.

AHCCCS has concluded a detailed review and analysis of the Emergency Triage, Treat, and Transport (ET3) model and has approved the implementation of a model based on ET3 in Arizona. The anticipated effective date is fall 2021. More details regarding the initiative will be released throughout 2021, prior to the effective date.

AHCCCS anticipates ample opportunity for stakeholder input related to the implementation of ET3.

For historical reference, between September 19, 2019 and October 1, 2020, AHCCCS developed the following tentative timeline to explore participation in ET3:

  • Late 2019/ Early 2020 - AHCCCS will research potential ET3 payment methodologies and model components.
  • Late 2019/ Early 2020 - AHCCCS will form an external stakeholder workgroup to discuss the ET3 model.
  • Second Quarter 2020 - AHCCCS will present its proposed State Plan Amendment at Tribal Consultation and post it for a 45 Day Public Comment Period.
  • Second/Third Quarter 2020 - AHCCCS will submit a State Plan Amendment to CMS outlining its proposed ET3 Payment Methodology.
  • Third Quarter 2020 - AHCCCS will initiate targeted education and outreach to ambulance suppliers and providers.
  • Third Quarter 2020 - AHCCCS will issue a public notice regarding the proposed ET3 program rates.
  • October 1, 2020 - AHCCCS will implement the ET3 program.