February 6, 2012

Consider yourself lucky

During times of a recession, it’s a wonder how any ambulance service can survive. With more and more people becoming unemployed, reimbursement for emergency services is at an all time low. This also means that less people are paying taxes to provide services like fire, police and EMS. Medicaid and Medicare programs have always had a history of cutting reimbursement during tough times. It’s now to the point where ambulance providers are only getting pennies on the dollar for what they bill.

All over the country, private ambulance services are going out of business or selling to larger providers. EMS jobs are not as abundant as they used to be. I happen to be fortunate as I work for a private ambulance service that remains financially stable right now. This of course has given me an opportunity to see what some people are willing to do get a job. We have paramedics not only moving from out of town, but out of state to work for us. It is unlike anything we have ever seen.

Now you would think that people working a secure EMS job would appreciate it, being that they can see whats going on around them. That isn’t exactly the case with everyone. I still hear attitude with crews when they are dispatched on a call for a skilled nursing facility or an inter-facility transfer. Sure, nobody enjoys those calls, but they are keeping services like us alive. While the 911 call for a stabbing is certainly exciting, it doesn’t pay the bills. As a matter of fact, 911 calls for the most part are a money loser.

If you are fortunate enough to be employed right now, remember that the calls you are running is the very thing keeping you in a job. When your employer cuts overtime, remember that it’s better than getting laid off. It’s far better to take a small hit now to ensure that you still have job in a year.

For those who are interested, I have another article I wrote a little while back about how a recession affects EMS.


Is EMS Recession Proof?

Hello readers. Today I am going to discuss the impact of a downward economy on EMS and the medical field in general. Until recently I actually believed that the medical field was immune to the economy. Like many others, I thought that since people can’t control when they get sick, that EMS and medical facilities would never suffer. That idea is absolutely wrong. Many things factor into financial hardships for medical facilities and EMS agencies during a recession. High unemployment rates and government cutbacks are just a couple examples.

Many American Citizens receive private health insurance as a benefit from their employers. When establishments are going out of business and people are frequently laid off, the number of insured patients significantly decreases. This can affect the medical field in general because people will not typically see a family physician for non life-threatening conditions, as they have no means to pay for it. While this may not affect the emergency call volume for EMS providers, it can certainly affect reimbursement. As it already stands, government provided insurance like Medicaid and Medicare already reimburse at an alarmingly low rate. In California, the average reimbursement rate is 14 percent. That means for every dollar that an ambulance service bills, they will only receive 14 cents. Even without a recession, this is still a huge obstacle for ambulance providers to overcome. With more and more people losing jobs, the amount of non-payers and government-assisted payers goes up.  Sounds bad enough right? It only gets worse.

When businesses collapse and people lose jobs, the government also suffers. People not working means people aren’t paying taxes. This equates to higher taxes and government cut backs. Medicaid and Medicare programs across the nation are tightening their belts, making reimbursement more difficult. Some states are even going as far as to delay payments. In addition to the decrease in cash flow, the state and federal government tend to place higher taxes on businesses, making daily operation even more difficult.

Despite all the doom and gloom that goes along with a recession, many agencies will prevail. Good financial planning, cutting overtime expenses and eliminating wasteful spending will be the key to success during these times of financial crisis.

As always, feel free to e-mail me with any comments or questions.