The ICMA just posted an interesting article written by Matt Zavadsky. The article discusses the economic and staffing crisis facing Emergency Medical Services (EMS) and how it presents an opportunity for system redesign.

I have to admit, after hearing someone else mention it I have to agree that the venue is… a little bit strange (A municipal manager focused publication), and it’s light on citations with some of the numbers. Having said all that, I’m a paramedic with an MBA and it’s good to see these types of discussions becoming more common. It’s long over due.

Some interesting highlights that stood out when I was reading the article.

The numbers are staggering

• 55 communities have lost their ambulance providers in the past two years.

• 59% of media stories on EMS focus on staffing issues, and 33% highlight economic challenges.

Literally no one is here for the pay check

• EMS is primarily funded through fees for services and public funding.

• Medicare and Medicaid reimbursements often don't cover the costs of providing services.

• Balance billing has become a contentious issue, affecting patient satisfaction.

My friends all left because it sucks and now there’s no one else left to do the job

• The cost of readiness and personnel are the most significant expenses for EMS agencies.

• The demand for EMTs and paramedics has surged, driving up wages.

• Training programs have been affected by the pandemic, reducing the number of certified professionals.

Can we stop saying “we’ve always done it that way”?

• Tiered Deployment: Not all EMS calls require Advanced Life Support (ALS). Basic Life Support (BLS) units can handle most calls, allowing for better resource allocation.

• Right-Sizing Response Times: Changing response time goals based on the acuity of the patient can help in resource optimization.