Rural Policy Research Institute EMS Study
From RUPRI in January 2021
Rural ambulance agencies, a fundamental component of the rural emergency medical services (EMS) system, are challenged by the following issues:
- long distances and challenging terrain that prolong emergency response and transport times,
- insufficient payment by insurers to cover standby and fixed costs,
- a changing workforce that has historically relied on volunteers but increasingly must include paid personnel,
- a lack of regional EMS plans to coordinate services, and
- insufficient State and Federal policy coordination across oversight agencies.
Specific public policies to address rural ambulance agency challenges could include the following:
- Increase ambulance payment to adequately cover reasonable standby and fixed costs.
- Consider EMS an essential service, the same as firefighting and law enforcement.
- Collect rural ambulance agency workforce data to better understand workforce needs.
- Expand the scope and authority of the Federal Interagency Committee on EMS to address rural ambulance agency payment and workforce challenges.
