How you can help keep EMS running in the US

EMS1 readers, here is your chance to lift a few fingers and contact your federal congress member to help keep EMS running in the United States. Major EMS organizations, including the National Association of EMTs and the American Ambulance Association are lobbying on Capitol Hill for Congress to extend the emergency Medicare Relief provisions that will expire on December 31, 2010.

You can help by contacting your Senator and House Representative now, during the last few weeks of the lame duck session.

EMS reimbursement has always been low, and the federal government knows it as well — the General Accounting Office (GAO) has reported it. In 2007, the GAO reported that ambulance providers are paid on average 6 percent below cost and 17 percent below cost in remote or "super rural" areas to provide transport services to Medicare patients.

Medicare reimbursement is often 50 percent of the revenue received by an ambulance service, so being chronically underpaid is a serious concern and unfair to those who have to help compensate the loss. The majority of both emergency and routine EMS in the United States is provided by small ambulance providers with 10 or fewer units. The loss of funding is difficult to absorb, if not impossible.

Congress responded to the report by extending payment increases of 2 percent for urban transports and 3 percent for rural transports in the Patient Protection and Affordable Care Act (PPACA). They also extended a payment boost of 22.6 percent for ambulance transports in remote or "super rural" areas. These are the provisions that will expire at the end of 2010.

Now, you might not care very much, especially if your local system is not supported by these monies. You should be though; even if you believe that the national EMS system should be tax supported, the fact is that it is not. We are a unique creature. We function in the worlds of public safety, health care and even public health simultaneously.

There are many services, both private and public, that depend upon the reimbursed fees to keep their operations going and keep units available for response.

Continued operations allows data collection and research to continue, allowing the profession to continue to improve and evolve. As new techniques, procedures and knowledge about emergency care impacts the outcome of critical patients, that information will spread across systems, including the one you are working in. We all benefit by the ongoing delivery by the national EMS system.

Here's another thing — your congress person really wants to hear from you, the constituent in his or her district. Most of the time they hear from lobbyists who represent the industry and other professional groups. EMS Day on the Hill was our first step to put line folks in front of their federal representatives.

It was touted as being successful; time will tell, but we're scheduled for another day next year. Most of us will not be able to make it to Washington. But, picking up the phone, sending an email, or writing a letter can be just as effective. We just have to do it, and have our voices heard by those we send to DC.

This is really important folks. Please reach out to your federal representative today and let them know how important this reimbursement is to the safety net that is EMS.

About the author

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor 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 writer, author of "EMT Exam for Dummies," has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at and connect with him on Facebook or Twitter.

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