Funding decisions need to stop nickel-and-diming the industry

Even in areas where there is no billing for EMS, 'free' doesn't mean 'cheap'

Editor’s Note:

Editor's note: Art doesn't think that funding decisions take EMS providers' dependency on ambulance transportation reimbursement into account, which may be why Texas ambulance officials have been charged with defrauding Medicare, and AMR in Mass. claims Blue Cross members owe $3 million.

To see both of these articles back-to-back makes me a bit sad and more than a little frustrated about how emergency medical care and ambulance transportation is funded in this country.

As long as we are seen primarily as a fee-for-service provider, we will continue to be hammered by the almighty healthcare dollar and the temptation to conduct possibly illegal acts in order to receive those funds.

The sad fact is most of the public really doesn't know the difference between emergency response and routine, scheduled ambulance transport. That includes our public officials.

Many EMS providers depend upon the reimbursement from ambulance transportation to fund the emergency response system. Yet it doesn't seem that funding decisions take that into account.

Emergency response is an expensive endeavor. The community expects its EMS system to be quick to respond and provide a high quality of service. Because of this, the cost will never be low.

Even in areas where there is no billing for EMS, "free" doesn't mean "cheap." Stop nickel-and-diming the industry, or reconsider what it takes to keep EMS systems afloat.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at

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  2. Legislation & Funding

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