CARE Act Seeks Medicare Reimbursement for On-Scene EMS Care to Reduce ER Visits

Bringing Balance to Emergency Care: The CARE Act’s Promise for EMS and Patients

When someone calls 911, the expectation is clear—help will arrive fast, and care will follow. But in many communities, that help often comes at a steep financial cost to the very emergency medical services (EMS) providers who deliver it. A new bipartisan proposal in Congress aims to fix that imbalance and modernize how emergency response is reimbursed.

A New Way to Support On-Scene Care

The Comprehensive Alternative Response to Emergencies (CARE) Act, introduced by Senators Susan Collins and Peter Welch, proposes a five-year pilot program that reimburses EMS providers for treating Medicare patients on-site instead of transporting them to hospitals.

This so-called “treat-in-place” model is simple but powerful. By compensating EMS professionals for providing medical care in the field—without mandating a hospital trip—the bill encourages smarter, more efficient care. During the COVID-19 pandemic, a similar approach saved Medicare an estimated $500 per encounter by avoiding unnecessary emergency room visits.

“EMS teams are healthcare providers, not just transporters,” said one emergency medical leader supporting the bill. “The CARE Act finally recognizes that delivering quality care doesn’t always mean a ride to the ER.”

Why It Matters for EMS and Medicare

In states like Maine, about 35% of EMS calls end without hospital transport. Right now, those costs fall entirely on EMS agencies, many of which are already struggling with tight budgets, staffing shortages, and rising operational demands. The CARE Act could offer them a sustainable path forward by reimbursing those non-transport services.

For rural EMS providers, this isn’t just about fairness—it’s about survival. These communities often rely on smaller EMS teams that can’t afford to absorb uncompensated care. The proposed reimbursement model would ease financial pressure, improve staff retention, and enhance local response readiness.

The Broader Benefits

Support for the CARE Act spans the emergency care landscape, from the American Ambulance Association to the National Rural Health Association. These groups see the legislation as a way to modernize reimbursement structures while improving outcomes for patients and communities alike.

Key benefits expected from the CARE Act include:

• Reduced strain on emergency departments and hospital overcrowding

• Better continuity of care for patients treated at the scene

• Lower Medicare costs through fewer unnecessary transports

• Stronger EMS system resilience and workforce sustainability

“This legislation builds on what we’ve already proven during the pandemic,” noted another EMS policy advocate. “When we empower medics to make the right care decisions in the field, everyone wins—patients, providers, and taxpayers.”

Looking Ahead

The CARE Act represents more than a policy tweak—it’s a shift toward smarter, patient-centered emergency care. If the pilot program succeeds, it could lay the groundwork for nationwide reform, redefining how the healthcare system values and funds prehospital medicine.

For EMS professionals who’ve long been the backbone of emergency response, the message is clear: the system is finally catching up to the reality of their work. The CARE Act could be the lifeline that brings both recognition and reimbursement to those who answer the call when it matters most.