My mom was a volunteer EMT for 15 years. Hearing her stories and the pride she had in serving the community motivated me to pursue volunteer opportunities. As a result, I spent 12 years as an emergency medical technician in Cassville, Wisc., a rural town located alongside the Mississippi river.
EMS providers represent a third of the nation’s first responders. While it is a rewarding career, it is extremely discouraging to watch EMS services struggle with funding. In 1973, more than $300 million was invested in EMS planning and operations. The following year, The Robert Wood Johnson Foundation appropriated $15 million to fund 44 regional EMS projects, the largest private grant to this day. However, there have been many changes in the availability of federal funding for EMS agencies. By 2002, only four percent of the $3.38 billion allocated by the Department of Homeland Security for enhancing emergency preparedness was dedicated to EMS.
To offset operating costs, patients are billed for transport to the hospital, with Medicare and Medicaid patients accounting for nearly 60 percent of services billed. Reimbursement rates, however, have not matched the cost of service, leaving EMS services to depend on private payers. With most volunteer and even paid providers solely having a background in providing medical services, billing expertise often is a gap, leaving many departments struggling to get the proper reimbursements to fund their operations.
Ultimately, EMS services still must find ways to pay the bills and deal with medical reimbursements – lives in their communities depend on their continued existence. To be operationally efficient, effective in providing services and a sustainable business, every EMS provider should consider the following three tips to help set their team up for financial success:
Assess inventory: Having an efficient inventory management system can help reduce costs. There are a few things to consider when assessing inventory, such as how much inventory is needed to meet product demand as well as replenishment demand. Be mindful of how standardizing products can help save costs. For example, if you order 10 different types of gloves, ask yourself why and what you’re doing with all those different types. Could you narrow it down to 2-3 to help save on the cost of the product?
Partner with other organizations: Consider how partnering with nursing homes, ACOs or even insurance companies can create high-value programs at low costs. In January, Anthem BlueCross BlueShield began paying for treatment without transport for patients in states where it offers commercial coverage. This speaks to the growing importance of finding new initiatives that will help sustain community paramedicine.
Look at consolidation: As resources and funding continue to shrink and diminish, services are consolidating between towns in order to survive. This includes county-wide or three or four areas within a specific sector of the community. An example of where this has been successful is southeast Wisconsin where seven municipal fire and rescue departments consolidated nearly 20 years ago. A report showed that had those municipalities not consolidated, they would have paid a total of $2.8 million more annually in operating costs in 2014 to achieve high-quality service.
Let your voice be heard: Lawmakers need more education about the growing issues facing the EMS community. It is important to rally with your state EMS association and schedule meetings with lawmakers who can help move the needle to ensure EMS is properly funded.
Knowing that EMS providers’ plates are full responding to emergencies and taking care of patients, global medical supplier Medline has launched an EMS division to offer both supplies and solutions that identify gaps in inventory management and billing procedures. In particular, the company has partnered with Fire Recovery USA to provide customized outsourced billing solutions to help met the needs of large municipalities as well as rural departments and even private ambulance services.
How EMS providers are impacted varies at the state level; the problems impacting them are pretty universal. Click here for a brief video highlighting EMTs, paramedics and firefighters having an open discussion about the issues impacting their EMS operations.
As federal funding continues to be a major hurdle across the country, it is more important than ever for providers to think outside the box when reducing costs so they can further meet the needs of their community.