Friday, April 29, 2016

Patients are Changing—What’s the Effect?

In all 50 States…
We stumbled across these startling statistics this week. In all 50 States of this United States of America the following numbers apply:
  • 50%- All 50 States now have an obesity rate higher than one-half of the population
  • 48%- Percentage of persons in all States living with one or more chronic illnesses
  • 20%- Persons of the age 65 or older make up at least 20% of each State’s population
What’s it all mean to EMS?
The numbers are revealing.

No wonder our call volumes have increased. No wonder most of our EMS systems are stretched to the limit- more runs, a shirking pool of providers and flat funding initiatives all combine for stressors for EMS in America.

Serving Bariatric Patients
Think about the innovations in EMS. When many of us began participating in the EMS system the bariatric stretcher was unheard of. Now, a large majority of EMS agencies have one or more of these devices and the cost of buying and maintaining this important piece of equipment is very pricey.

The growing number of bariatric patients require extra manpower and special precautions so we all do not hurt ourselves when providing treatment and transport for these individuals. All of this takes dollars and resources that our forefathers in EMS were never challenged with solving.

Longer Life Expectancy = More Persons to Serve
Advancements in treatment of persons with chronic illnesses has lengthened the life-expectancy for these individuals which is wonderful, but those persons need to be moved from one place to the other the longer they live. More people, living longer require more people and ambulances on the street.

Upside-Down Medicare Funding
We read that the Medicare trust fund is being depleted at an alarming rate. Truth is, at the inception of Medicare there were more people below Medicare age paying into the trust fund than were taking from it.

Now we have the reverse.

More people are taking benefits form the Medicare fund, at least 20% in each and every State qualify, than are paying into it and that’s not counting those persons receiving disability benefits as part of the rise in chronic condition survivors.

Patients are Changing—What’s the Effect?
Work Smarter to Overcome the Obstacles
How do we overcome what the changing patient population and modern EMS has thrusted onto all of us that are part of EMS in America in 2016?

We have to work smarter.

We have to be efficient. We must employ billing practices that are 100% compliant and yet beat the trees for every single dollar. This is exactly why we’re seeing a growing number of billing operations changing their scope and practice- consolidating, outsourcing, employing digital means whenever possible- in order to funnel more dollars to drive service to more patients.

We must be somewhat aggressive in chasing every dollar that is possible. We must educate the public that the ambulance bill they are receiving insures that the service will be there tomorrow when they dial 9-1-1 for their next emergency.

We must denounce fraud and abuse and attack it wherever we find it. We should police our own ranks before the regulators are forced to do it for us and then we all suffer because of it.

We must be smart about deploying other resources when an ambulance may be a convenience over a necessity. Additionally, we must educate the patient population more effective about when it’s appropriate to activate the EMS system versus calling for a less emergent and costly means of getting from one place to the other- wheelchair van, public transportation, private conveyance, etc.

Last but not least, system providers- the people on the street- must form a partnership with management and the billing office to insure that every detail is documented in the Patient Care Report. Nothing can be left out. Every angle of treatment should be reviewed in light of funding and for efficiency in the system both on the expense and the reimbursement side of the equation.

Together we’ll figure it out and move forward with EMS for the future that covers a changing patient demographic.

The Ambulance Billing Services blog is brought to you as an educational tool by Enhanced Management Services, Inc. Enhanced Management Services, Inc. is an all-EMS third-party billing contractor serving Fire/EMS agencies across the United States. To learn more about who we are and what we do, please visit our website at and click on the “Get Started” button on any landing page.

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