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 of 2019 for ambulance providers and suppliers who wish to participate in ET3 for Medicare Fee-for-Service (FFS) members. Applications are due back to the CMS Innovation Center on September 19th, 2019 by 11:59 pm EST.

Update: CMS has extended the application period for the Request for Applications (RFA) to October 5, 2019 at 11:59 P.M. EST.

What is AHCCCS’ Role in ET3?

CMS and AHCCCS have both recognized that long term program sustainability of the ET3 Model will be dependent upon the participation of multiple payer sources. Accordingly, the Request for Applications (RFA) gives preference to providers whom have partnered with multiple payer sources, including their State Medicaid Program, as this increases the likelihood of having a long term, sustainable ET3 program.

Applicants for the RFA are encouraged to submit Letters of Intent (LOI) for these additional payer sources. AHCCCS is currently exploring participation in the ET3 Model, and to provide support to our EMS providers within the State of Arizona has issued a Letter of Intent for their use in the RFA.

AHCCCS Letter of Intent for the ET3 Program

Exploratory Timeframe

In the interim time period between September 19, 2019 and October 1, 2020, AHCCCS has 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.

AHCCCS Letter of Intent (LOI)

AHCCCS Letter of Intent for the ET3 Program

Additional Information

Interested providers are encouraged to subscribe to the AHCCCS ET3 ListServ, which emails news alerts regarding ET3 directly to a provider’s email inbox. You may unsubscribe at any time by clicking the Unsubscribe link at the bottom of every email. Subscribe here.

AHCCCS intends to form an external stakeholder workgroup to further explore participation in the ET3 model and meetings are anticipated to begin in late 2019.

For questions on AHCCCS participation in ET3 or for ambulance providers and suppliers that are interested in participating within the external stakeholder workgroup, please outreach Alexa Kaumaya at Alexa.Kaumaya@azahcccs.gov.