Good morning readers. Today I will bring up the topic that everyone in EMS has been talking about. Pay. Lack of adequate compensation, benefits and retirement have caused many problems in EMS systems across the United States. Paramedic and EMT shortages have taken their toll on response times, work load and the amount of ambulances that are available on the streets. Someone interested in a public safety job, could easily become a police officer, fire fighter or correctional officer within the amount of time it takes to become a paramedic. All three of those jobs offer better pay, benefits and retirement plans. This leaves many EMS professionals looking to their employers and asking “Don’t you see the problem here? Can’t you just pay us more?”
Well if the solution was as easy as increasing compensation, the shortage wouldn’t exist. Many complications factor into the cause of low EMS pay. Poor insurance reimbursement, abuse on the 911 system and constantly increasing costs to do business all play a roll in the current financial situation seen nation-wide for EMS providers.
With Medicare and Medicaid plans only reimbursing pennies on the dollar, it is a wonder that any ambulance service can stay in business. Currently here in California, Medi-Cal reimburses 14 cents on the dollar for ambulance service. On top of that, new legislation has passed decreasing that by another 10 percent. State and federal funded insurance plans make up a very large percentage of payors. Unlike private doctors offices and even hospitals, ambulance providers do have the option of turning away government funded insurance patients. This problem alone is probably the biggest contributer to low EMS salaries.
Most doctors offices do not accept government funded insurance. With only a select few clinics in most areas seeing these patients, many of them are turning to ambulance services and emergency rooms for non-emergency medical needs. If the insurance angency feels that the ambulance ride or ER visit was not justified, then they don’t pay the bill. This also makes up a large portion of the patients transported every day.
Constantly changing government policies and regulations often hit ambulances services in the wallet. In the county where I work, all of the ambulance services have recently been required to switch to paperless documentation systems. This of course has made a huge fiscal impact. This is only one example of constantly increasing costs of doing business. Expiring medications, broken and outdated equipment also contribute to this problem.
So is there light at the end of the tunnel?
Unfortunately it doesn’t appear so anytime soon. With government constantly cutting costs and unemployment rates on the rise, it will take some time before we see any changes for the better. But don’t let this discourage you. There is still money to be made in the EMS field. Promotions to field supervisor and management are one way to increase pay and benefits. There are some on-line EMS Management degrees available that would open doors for jobs at the state and county level as an EMS director, coordinator, or as a operations manager at a private ambulance service.
Despite all the problems in the EMS system today, it still remains a promising career path. Hard work, dedication and the ambition to further your career will ultimately lead to success.
