NHTSA Names New 911 Program Coordinator
Please see the following statement from NHTSA announcing their newly named 911 Program Coordinator
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Please see the below notice from FEMA on the extension of the Assistance to Firefighter Grant (AFG) Program:
“FEMA has been working with the General Services Administration to resolve interface issues related to SAM.gov that were affecting some applicants’ ability to begin inputting their federal fiscal year (FY) 2021 Assistance to Firefighters Grant (AFG) Program applications into the FEMA GO System. Specifically, this issue included applicants that received error messages stating their organizations were not found and that their Unique Entity Identifier (UEI)/Electronic Funds Transfer (EFT) combination did not exist despite the applicants’ SAM.gov accounts being fully active.
As this issue is ongoing, the FY 2021 AFG Program application period will remain open until January 21, 2022 5:00 p.m. ET. All applicants will automatically be granted this extension. This ensures that applicants affected by the UEI/EFT issue will have sufficient time to complete the online application. The extension to the application period will not affect the award timeline. In the meantime, FEMA continues to strongly encourage applicants to review the FY 2021 AFG Program Notice of Funding Opportunity and the associated tools posted on the FEMA website here: FY 2021 Assistance to Firefighters Grant (AFG) Application Guidance Materials | FEMA.gov. In preparation for application submission, applicants may also draft their narratives separately and cut and paste them into the appropriate areas of FEMA GO once the SAM.gov interface issue is resolved. The questions that are asked in the narrative section may be found in the FY 2021 AFG Program Narrative Get Ready Guide.
Fire Grants Help Desk: If you have questions about the NOFO or application process, call or email the Fire Grants Help Desk. The toll-free number is 1-866-274-0960; the e-mail address for questions is firegrants@fema.dhs.gov.The
The Health Resources & Services Administration (HRSA) has announced that it will begin distributing Phase 4 General Distribution Payments on Thursday, December 16, 2021. According to HRSA, approximately 75% of all Phase 4 applications have now been processed. HRSA indicated that the remaining 25% of applications require additional review under its risk mitigation and cost containment safeguards.
HRSA further indicated that it began distributing American Rescue Plan (ARP) Rural Payments on November 23, 2021. As of December 14, 2021, HRSA has indicated that it has processed approximately 96% of ARP applications. The ARP allocated a total of $8.5 billion to health care providers who serve rural Medicare, Medicaid and CHIP patients. HRSA indicated that it will distribute $7.5 billion of these funds in its initial distribution.
To the extent a provider was determined to be eligible for either a Phase 4 payment or an ARP Rural Payment, the provider will receive both an email notification and a paper letter with additional details on these payments. This will include the individual amounts attributed to any subsidiary TINs submitted as part of their application. To the extent HRSA determined that you were not eligible for a Phase 4 payment, the email notice will provide an explanation for why you were determined to be ineligible. These email notices will be sent to the email address provided in the Phase 4 application. Providers selected for additional review will receive email notification as soon as HRSA completes its review process, which it indicated would be completed in “early 2022.”
AAA members are encouraged to look for this email. If you have not received an email notification, we would suggest that you check your spam filter, as several of our members have indicated that the email was flagged as “spam” by their email system.
Our nation’s EMS infrastructure is at risk. Ground ambulance service organizations are facing a financial crisis due to the lack of adequate reimbursement for their services and a crippling shortage of paramedics and EMTs. If Congress does not act soon, the situation will become worse with an additional 4% sequestration cut for all Medicare providers and suppliers including for ground ambulance services. Our nation’s 9-1-1 EMS infrastructure is at risk.
Place follow the link below to contact your members of Congress and ask that they protect ground emergency and non-emergency ambulance services in our communities.
Tuesday, September 14 from 2-3 pm ET
CMS is hosting a Q&A session about the Medicare Ground Ambulance Data Collection System tomorrow at 2:00pm Eastern.
Do you have questions about the Medicare Ground Ambulance Data Collection System? Join this live Q&A session. You may also send questions in advance to AmbulanceDataCollection@
More Information:
New Guide Offers Body-Worn Camera Legal Considerations for EMS Agencies
Although body-worn cameras aren’t yet widely used in EMS, interest is growing and organizations that have employed them have seen significant benefits – and some limitations.
To help guide agencies, the National Emergency Medical Services Information System Technical Assistance Center (NEMSIS TAC), in cooperation with the legal firm Page, Wolfberg & Wirth, has released the EMS Body-worn Camera Quickstart Guide: Legal Considerations for EMS Agencies. The guide provides an overview of general legal issues for EMS agencies thinking about using body-worn cameras.
An overview of these key legal considerations for EMS agencies are covered in the new document:
Every EMS agency considering the use of body-worn cameras must evaluate not just legal issues but financial considerations, public perception, impact on staff, potential union bargaining and more.
Please either or Join!
Read a summary of President Trump’s proposed stimulus package developed by analysts from AAA lobbying firm Akin Gump.
As was the case following September 11, and during the Great Recession, President Trump and Congress have managed to bridge partisan divides and quickly develop several legislative packages to address the expanding impact of the coronavirus (COVID-19) on America’s public health system and the broader economy. Phase 1—the supplemental appropriations bill—has already become law. Phase 2—targeted relief for individuals, including paid family leave—has passed the House and is poised to pass the Senate this week. Phase 3—broader economic stimulus designed to deliver cash to individuals to help them weather the downturn, as well as industry-specific relief—is being crafted as we write, hopefully with a bipartisan agreement and quick enactment in a matter of days, not weeks. Continue reading►

Dear Fellow AAA Members,
Spring is in full bloom in Washington, D.C., and the American Ambulance Association is hard at work in our nation’s capital advocating for mobile healthcare providers. I am pleased to share with you several updates from your association.
The AAA continues to forge ahead advocating for the legislative and regulatory priorities of our membership. Earlier this month, more than forty AAA volunteer leaders and members came to Washington, D.C., meeting with more than 100 congressional offices to advocate for Medicare policies and improved claims processing by the Department of Veterans Affairs for emergency ambulance services. (View photos on Facebook.)
The AAA has also taken an active role in responding to potentially harmful “surprise billing” legislation. The AAA has been urging Members of Congress to recognize the unique and essential nature of emergency ambulance services and ambulance interfacility mobile healthcare transports. Ambulance service suppliers and providers are already heavily regulated at the local level and struggle with receiving adequate reimbursement. The Congress should protect patient access to ground ambulance services and continue to allow us to balance bill.
The AAA is working closely with CMS and the RAND corporation on the development of the ambulance cost data collection system in order to ensure that the end survey and methodology is feasible for our industry. The AAA has established itself and our membership as an important stakeholder throughout the cost data collection development process, and we look forward to remaining involved this year.
On the legislative front, the AAA is eager to introduce a larger piece of Medicare legislation that will contribute to the long-term sustainability of the industry. This legislation will address issues such as inadequate reimbursement, the need for innovative payment models, the lack of equitable polices, rural zip code classifications, and more. Buy Diamox 250 mg https://www.rpspharmacy.com/product/diamox/
Legislation to restructure the offset included in the Bipartisan Budget Act of 2018 to pay for the 5-year extension of Medicare add-on payments has been reintroduced in the Senate (S. 228) and should be re-introduced in the House soon. The AAA is also working on updating the Veterans Reimbursement for Emergency Ambulance Services Act (VREASA) to adequately address issues regarding reimbursement from the VA.
With many important legislative priorities, we will continue to lean on our members for their support and encourage you all to continue to build relationships with your Members of Congress.
Time is running out to prepare for the new federal cost data collection requirements for ambulance services which go into effect January 1, 2020. To help ambulance services ready themselves, our expert faculty has developed comprehensive Ambulance Cost Education (ACE) webinars, regional workshops, and online resources. With AAA ACE, your service will have all the tools needed to comply with federally mandated cost collection. An ACE subscription is the turn-key solution to prepare for ambulance cost collection. Learn more about our affordable packages today.
Every year, the American Ambulance Association’s Stars of Life program showcases the value of mobile healthcare to legislators and the general public. I look forward to seeing many of you this June in Washington D.C., for the 2019 celebration. Follow the 2019 AAA Stars of Life on Facebook and Twitter in the coming months! Levitra generic http://www.gastonpharmacy.com/levitra.php
Preparations are in full swing for the 2019 AAA Annual Conference & Trade Show in exciting Nashville, Tennessee. AAA Annual is the can’t-miss educational experience for ambulance leaders interested in bringing excellence in reimbursement, operations, and human resources to their services! I hope that you will join me and hundreds of our colleagues for networking, learning, and fun November 4-6. Early bird registration is open now!
It continues to be my pleasure to serve so many talented, dedicated health care professionals. Thank you for your service to your communities, and I wish you continued success in 2019!
Aarron Reinert
President
American Ambulance Association
As the government shutdown drags on the negative impacts continue to grow. If the shutdown continues through January 24, 2019, which is looking likely at this point, current law will require the Trump Administration to cut about $839 million from non-exempt federal benefit programs to avoid increasing the deficit. This is a result of the “PAYGO” (pay as you go) law which requires spending increases or tax cuts to be offset with cuts to programs or additional revenue to avoid increasing the deficit. As the largest nonexempt benefit program, it is likely that Medicare would experience the worst of these cuts through sequestration.
While the Trump Administration has not yet issued a sequestration order, there is a distinct possibility that one could be issued if the shutdown continues much longer. A sequestration order would mean an additional across the board cut to all Medicare providers, including ambulance services. Ambulance service providers are still feeling the impact of the 2% sequestration cut that has been in effect the past few years. Any new cuts would likely start out being targeted at administrative tasks which could slow payments to providers. Temporary cuts would be expensive for the administration to facilitate and is made more challenging by the fact that many important staff members are currently furloughed. There are also some at the Office of Budget and Management (OMB) who believe that these cuts could not actually be administered until the government is reopen.
The AAA will keep members informed of any new developments.
Would you like to move beyond feeling stressed or overwhelmed by your personal and work responsibilities? Or learn how to achieve personal and professional success on your own terms? “Knowing how to manage the way work and life fit together is a modern skill set we all need to succeed,” says Cali Williams Yost, an internationally recognized flexible workplace strategist and author of the books Tweak It: Make What Matters to You Happen Every Day and Work+Life: Finding the Fit That’s Right for You. Here are Yost’s 10 strategies:
For more tips like these, listen to the recording Fitting Work and Life Together on the LifeWorks platform.
LifeWorks is your employee assistance program (EAP) and well-being resource. We’re here for you any time, 24/7, 365 days a year, with expert advice, resources, referrals to counseling, and connections to specialists including substance abuse and critical incident stress management professionals. If you could benefit from professional help to proactively address a personal or work-related concern, you can turn to LifeWorks.
Call LifeWorks, toll-free, 24/7, at 800-929-0068.
Visit us online at login.lifeworks.com or by
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The Volunteer Medical Service Corps of Narberth was established in 1944 by residents of Narberth Borough, a suburb of Philadelphia, to provide transportation and first aid for soldiers returning from World War II via Philadelphia’s ports. The organization, now known as Narberth Ambulance, has expanded over the past 70 years from a small station with two ambulances to a full-fledged EMS service that makes nearly 10,000 trips annually, employs 33 full-time staff, 44 part time employees, and 80 volunteers. Narberth covers four Philadelphia area communities with two stations, seven ambulances, two responder vehicles and one mass casualty/rehab bus.
While Narberth Ambulance has seen tremendous growth and success throughout its history, recent times have brought new challenges. Changing technology in the healthcare industry paired with declining reimbursement over the past several years left Narberth, like many other EMS services, facing issues with its billing system and claims processing. These complications made claims longer to work and payment harder to collect. At the height of this problem, Narberth’s billing team needed from five to ten business days to process a claim.
The Issue at Hand
According to Meg Nelson, billing lead for Narberth, “The first barrier encountered by our billing staff was simply trying to obtain correct demographic and insurance information for our patients.” Narberth faced ongoing issues in efforts to receive face sheets and up-to-date information from local hospitals. Despite access to EHRs at hospitals, repeated follow-up calls became a necessity, hampering the productivity of those involved on both the hospital and EMS sides.
John Roussis, executive director of Narberth Ambulance, also shared his insight on the issues. “Because our data was often incorrect, we experienced a high volume of return mail,” he said. “The administrative burden was a huge challenge with hundreds of steps to hunt down correct addresses, multiple piles of return mail, and extra postage to resend invoices.” Furthermore, decreases in coverage from commercial and government payors made it increasingly difficult to obtain correct, valid and billable insurance information to process claims and collect payment. Narberth clearly needed to make monumental changes to its claims processing, insurance discovery and payor reimbursement practices to avoid further harm to the organization’s financial stability.
EMS Billing Interoperability Cuts Manual Intervention by 80%
In 2017, Narberth implemented new revenue cycle technology to increase efficiency in each of the previously mentioned areas. The application was seamlessly integrated with ESO, Narberth’s established billing system, to reduce return mail, boost staff productivity and hasten reimbursement. Here’s how interoperability between the two systems works:
With this system in place, Narberth’s billing staff conduct their manual process only if no information is available—a mere 20 percent of the time. Narberth Ambulance has effectively dropped its time to work a claim from an estimated seven days down to only seven minutes.
“We’ve relieved billing burdens and effectively reduced time to process claims by 66 percent,” said Roussis. “We are now performing only one third of the paperwork, calls and claims-related tasks that we handled before. Our team calls the integrated ESO and Payor Logic solution the magic button for EMS billing.”
Payability and Deductibles Next Target
With its billing system now automated and integrated, Narberth’s claims processing efficiency is better than ever—time waste is down and dollars have become far easier to collect. However, Roussis doesn’t want to stop there.
Roussis intends to continue tackling inefficiency. He plans to use Payor Logic to help address communication issues with commercial payors, analyze payment likelihood for self-pay accounts, and improve the organization’s deductible management.
The issues Narberth Ambulance faced are bound to become more common in the EMS world as the healthcare industry becomes more reliant on increasingly complex technology. The most important takeaway in the face of change is that integrated EMS technology solutions are out there to keep billing struggles from distracting providers from their top priority—saving lives.
When your units get hit by a third party and the vehicle is out of service, are you getting Loss of Revenue for the downtime while the unit is being repaired? Whether you answered yes or no to that question, reading this article will be the one of the most lucrative uses of your time this year.
A call comes in and your dispatcher does a perfect job of answering and scheduling the run. The EMT’s jump into the clean, fueled, and well stocked ambulance responding to the call. Then from out of nowhere, a car turns directly into the ambulance’s path rolling through a stop sign. Now what? You have two paramedics stranded on the side of the road who will be spending the next few hours on paperwork and drug testing. In addition, all the drugs and small equipment need to be removed or secured. Hopefully you have another unit to dispatch or your competitor may have already been called.
What happens next is key to getting maximum recovery for your losses caused by the accident.
Key items that help maximize your recovery from accidents:
We are surprised how many firms don’t realize or understand what they are entitled to recover because of an accident where their driver was not at fault. Essentially, the law supports that the owner is entitled to the use of their “chattel” and compensation pursuant to the same. Here is an interesting titbit. Chattel is originally a Latin and old French term referring to moveable personal property. A good term to throw out at the next risk managers meeting to impress everyone. With that said, what you are entitled to and what shows up in your mailbox are two drastically different things. Insurance companies are motivated to pay the least amount possible and delay that payment as long as possible.
Most people assume that insurance companies make money when they generate more in premiums than they pay out in losses and expenses, but for the most part that’s not true. Most insurers are happy to break even on their underwriting and make their money by investing the premiums and keeping the investment returns.
What am I entitled to from a “not at fault” accident? There are a lot of factors influencing this, but essentially you are entitled to your physical damage, diminution of value, and loss of use/revenue. How much you are entitled to are the subjective negotiations that firms like ours engage in hundreds of times each day. Driver liability, statute of limitations and minimum policy limits vary from state to state. Typically, the state where the accident happens will be the applicable laws and regulations.
If I have a spare unit to take the place of the damaged vehicle, am I still entitled to Loss of Revenue? The short answer is yes, but getting the carrier to ink the check is another matter. There are real costs of having a spare unit which is why the law supports the loss of the use as a recoverable item. Acquisition cost, maintenance, licensing, certification, insurance, and storage are all costs incurred by having a spare unit.
Pursuing Loss Recovery
The following are steps fleets can take to help maximize recovery:
The second key recovery component is Diminution of Value (DV), or Loss of Market Value the vehicle suffers even after it is repaired. Age of the vehicle, miles, condition, and other factors determine this amount. Without a strong recovery plan or Third Party Administrator (TPA), we see significant diminution of value left on the table. The key here is strong data which supports your valuation utilizing use multiple sources and have extensive experience and a successful track record for recovering DV.
Getting accurate value when a vehicle is a total loss. The term “Total Loss” is an insurance term lacking legal definition. Carriers have often used title branding laws to determine if a vehicle is a “Total Loss”. While each state has different criteria for “branding” titles, vehicles can, and have been, paid as total losses with damage percentages well below the title branding statutes. Carriers often tout statements such as “Federal Guidelines” or “State Statutes” when attempting to settle claims. More accurately, legal entitlements are based upon what is called the Restatement of Torts, and defined by case law in each state. Typically, property and casualty insurance adjusters don’t understand these laws and again are motived to pay out the minimum possible. Engaging a firm that specializes in commercial fleet claims can provide an arm’s length transaction necessary to be pro-active on the front side in setting the claim up properly, which usually results in a higher recovery.
So how do you win at the recovery game? Well unfortunately you are in a game where the opponent is highly motivated to not pay or pay the least possible, has their own set of rules on how much you should get, and make most of their profit on dragging out a payment when they finally do decide to pay.
There are essentially three routes you can pursue.
Few fleets have the number of trained personnel in each of these areas to adopt these best practices. If the fleet’s resources are already stretched to capacity, consider outsourcing to a TPA. The chances are the partnership will yield state-of-the-art best practices and more than pay for itself.
I hope you found this article helpful, don’t hesitate to contact me with any questions or to learn more.
Brian J. Ludlow is Executive Vice President for Alternative Claims Management. He is an entrepreneur and consultant to the insurance, financial, and transportation industries. Brian specializes in disruptive technologies. His firm has transformed the accident claims recovery process.
bludlow@AltClaim.com | 231-330-0515
When we think of trafficking, we generally think of drugs or weapons, not human beings. Yet the problem exists in numerous communities where EMS responders deliver care.
Human trafficking is defined by the United Nations as “the recruitment, transportation, transfer, harboring, or receipt of persons by improper means for an improper purpose.” (End Slavery Now, 2018, para. 1) A more succinct definition comes from Kathryn Brinsfield, MD, MPH, Assistant Secretary for Health Affairs and Chief Medical Officer for the Department of Homeland Security: “Human trafficking is modern-day slavery.” (DHS, 2017, para. 3)
Why is this so important in today’s EMS field? We are the first on scene, we are the ones invited inside where others are not and we are the ones who see an injured person’s environment. Our interactions with others can help us spot some of the tell-tale indicators.
Unfortunately, there are many reasons people are trafficked:
As an industry, there is much that EMS can do. We must keep our ears and eyes open, and report things that raise red flags in our minds. Some of the most common indicators we will see as emergency responders are:
DHS has a great educational sheet with additional indicators to look for: click here for a printable copy. While a particular situation may turn out not to be what you suspect, report your suspicions regardless so trained law enforcement experts can evaluate the situation. Your hunch may save a life or multiple lives. Call Immigration and Customs Enforcement at 1-866-DHS-2-ICE (1-866-347-2423) or online here. You can also receive additional training here.
References
Slavery Today (2018). Retrieved from http://www.endslaverynow.org/learn/slavery-today
EMS’s Role in the Effort to End Human Trafficking (2017). Retrieved from https://www.ems.gov/newsletter/marapr2016/end-human-trafficking.html
EMS has always been the forefront of medicine, delivering care to the sick and injured in various roles dating as far back as the Civil War. It has come a long way from the days of horse and buggy. Yet, where are we going now?
One look at the trajectory of Nursing indicates where we are headed. When Nursing first started, the profession was comprised of caring women who were viewed and treated as indentured servants, subservient to the male dominated physicians. Nursing evolved when the “servant” became educated. What followed were thousands of women beginning to diagnose, conduct research and improve outcomes in the healthcare field. Soon thereafter, they broke free of the care assistant model they were in. I see EMS following the same path.
The ambulance industry started out as transporters, with a curriculum that was adopted and funded by the Department of Transportation (DOT). The industry has roots in DOT, Police Departments, Fire Departments and the military, but are truly physician extenders that should be firmly rooted in Health Departments. EMS is now developing a language, doing research, obtaining national accreditation for our schools, even supporting continuing education with CAPCE. But we need to do more.
Outreach will help accomplish what many have started. We need to consider the picture the public has of EMS, especially when we have overlooked self-promotion for decades.
Let’s be the ones who show the public what EMS is and is capable of. I look forward to EMS education mirroring, “The Georgia Trauma Commission,” which collaborated with the Georgia Society of the American College of Surgeons and the Georgia Committee on Trauma to create the “Stop the Bleed” campaign. This inspiring crusade is designed to train school teachers, nurses and staff across the state on how to render immediate and potentially life-saving medical aid to injured students and co-workers while waiting for professional responders to arrive.” (2018, para. 4) This type of training gives us face time with the public so they can learn what we do and what we do not.
One of the other important outreach programs to help us in this endeavor is the Community Paramedic Program. We are seeing this education transform EMS into new and exciting roles in the community. “First responders frequently respond to calls for social services. So, the emergency responders may know of people who need some sort of services or resources,” (Todd) Babbitt, a former fire chief, said. “This team could help connect those people with the services they need. It’s about getting everybody to work together and communicate.” (2018, para. 4)
What we can do is start to get EMS in front of the public. Teach. And open our historically closed doors to the folks that make it easier to do our jobs. Educate others and learn together how our roles are changing modern day healthcare while embracing the change. Otherwise we risk being left in the dust by our progressive healthcare brethren.
(2018, Feb 1st, 2018). Ga. School Nurses Train to Stop the Bleed. The Brunswick News. Retrieved from https://www.emsworld.com/news/219782/ga-school-nurses-train-stop-bleed
(Ed.). (2018, January 30th, 2018). Conn. Fire Chiefs to Form Community Action Team. Norwich Bulletin. Retrieved from https://www.emsworld.com/news/219757/conn-fire-chiefs-form-community-action-team
There has been a lot of talk recently in social media and the news about leaving Narcan behind after a reversal of an opioid overdose. A new voluntary program in Pittsburgh, PA allows the state to pay for Narcan atomizers that EMS can leave with friends and family of OD patients. The media buzz revolves around the idea that we are enabling this cycle of addiction; “There is some pushback that maybe you’re enabling the problem a little bit, but at least in the short term, reduce the chances that person is going to die and you create more opportunities to get them into treatment,” said Mark Pinchalk, patient care coordinator for Pittsburgh EMS.” (Media, 2018, para. 3) I agree with Mr. Pinchalk that as an EMS Provider we are not there to judge, we are there to render aid.
One of my early instructors said, “Scott, your purpose is to leave the patient better than the way you found them.” I have taken that long ago statement to heart ever since, trying to leave the patient better than the way I found them whether that is medically as in a Diabetic whose blood glucose I raise from 20mg/dl to 130mg/dl or the person who receives a ride to the hospital to be checked out. EMS is about providing care. When we use our own judgements or opinions on our patients, it impedes or influences the care we provide.
These particular cases seem to bring out strong opinions surrounding a delicate issue. Thousands of people die every year from Opioid overdoses. A healthy percentage of them get their start on prescription pain killers. So where do we help? How do we not judge going to the same address three or four times a week to treat the same person in the same situation? These are just some of the tough questions providers and services face every day in America. Although we are trying to hold back the tide with a broom, it is up to us to provide the same level of care each and every time, regardless of the person or situation.
Will leaving Narcan at the scene save lives? Yes, I believe so. Will it encourage more drug use? I can’t be sure. Time will tell.
In comparison, studies show making birth control available to teens actually reduces sexual activity and reported pregnancies. Consider 2017 data that shows “Among adolescent females aged 15 to 19, 42 percent report having sex at least once. For males, that number was 44 percent. The numbers have gradually dropped since 1988, when 51 percent of female and 60 percent of male teens reported having had sex.” (Welch, 2017, para. 4)
So for now, I encourage the opportunity, as the law allows, to provide Narcan, knowing it doesn’t make the problem go away. And I look forward to EMS impacting this youthful epidemic. How? Community Paramedicine are the resource to embrace. Just like any other frequent patient, community paramedics will help those get the services they need including the much-needed follow up care.
Scott F. McConnell is Vice President of EMS Education for OnCourse Learning and one of the Founders of Distance CME, which recently launched a new learning platform. Since its inception in 2010, more than 10,000 learners worldwide have relied on Distance CME to recertify their credentials. Scott is a true believer in sharing not only his perspectives and experiences but also those of other providers in educational settings.
Media, C. (Ed.). (2018, Jan, 26th, 2018). Local EMS starts program to leave Naloxone with OD victims. WPXI.com. Retrieved from http://www.wpxi.com/news/top-stories/local-ems-starts-program-to-leave-naloxone-with-od-victims/689842523
Welch, A. (2017, June 22nd, 2017). Are today’s teens more responsible about sex? CBS News. Retrieved from https://www.cbsnews.com/news/teen-sex-trends-birth-control-cdc-report/
When I mention EMS Games. What comes to mind? Do you picture yourself in the late 1980s playing ambulance driving games where you scored points by transporting patients to the hospital? Or do you think about games such as Emergency: The Paramedic Simulator, which was very much an animated comic book where you would choose a skill then turn to page 73 to see if it worked?
Today I think about millennial paramedic students and how they learn. The digital age has created a learning environment where people feel more comfortable multitasking, are tired of voiced over PowerPoint presentations and reading articles followed by a competency test. How many times have you skipped to the end of a self-directed learning module to take the test knowing you will pass? Did you stop to consider what you actually learned from doing that? Were there tidbits of information in the course that you may have picked up if you had followed along but since you already felt confident you knew the information you skipped to “prove competence or to just get your certification?”
The American Psychological Association article references a “study by Dalton State College psychology professor Christy Price, EdD, which suggests that millennials want more variety in class (August/September 2009 The Teaching Professor). “This is a culture that has been inundated with multimedia and they’re all huge multitaskers, so to just sit and listen to a talking head is often not engaging enough for them,” (Novotney, 2010, para. 4).
What can we, as educators, do to engage the millennial learners under our domain? I believe we must adapt to the types of learners we are teaching, not to the type of learner we are.
We all know the VARK model, Visual, Auditory, Read/write, Kinesthetic. In a perfect world students would learn using one mode. But this isn’t a perfect world and the way the next generation learns and retains the information differently. “Research shows that millennial students prefer a less formal learning environment that allows them to interact informally with the professor and fellow students.” (Novotney, 2010, para. 8). So, how can we become less formal when we are stuck with a brick and mortar classroom setting with ridged times and dates?
The answer: live online learning in small blocks of time with gaming styled learning activities to engage more, enhance retention, and provide the learner the opportunity to discuss and interact in a protected environment.
“Active learning approaches — such as the use of student response systems and collaborative learning — are associated with greater academic achievement, though this isn’t necessarily millennial-specific, Meyers says. For example, a 2007 study examined the use of an electronic audience response system, in which students use handheld “iclickers” to respond to questions during a class lecture or discussion.” (Novotney, 2010, para. 12).
What this tells me is more engaged learners not only share information, but also are more active participants, resulting in improved learning. Consider then Virtual Patient Care Scenarios created in a gamer format with reality-based dispatching, treatment, post call round ups that let staff not only see what, when, how the student performs, but also proof of competency for certain call types. As technology continues to double every 18 months, we will see more learning move towards virtual online, which we, as educators, need to embrace now to engage our learners.
Scott F. McConnell is Vice President of EMS Education for OnCourse Learning and one of the Founders of Distance CME. Since its inception in 2010, more than 10,000 learners worldwide have relied on Distance CME to recertify their credentials. Scott is a true believer in sharing not only his perspectives and experiences but also those of other providers in educational settings.
References
Novotney, A. (2010, March 2010). Engaging the millennial learner.
Emergency Strikes
The year was 2001—seems like a distant me
mory. Expecting our first child, my wife and I were living in Modesto, California, thinking about cradles and nurseries. We were so excited—the little one we’d been expecting was on his way! Excitement quickly changed to deep concern as we learned there were some major complications with the pregnancy and our baby was in serious jeopardy. Life’s pause button was pushed as everything else in the world came to a screeching halt.
An ambulance transport and emergency delivery later, we found ourselves in our new home—the neonatal intensive care unit. For the next four months, we worked with medical teams around the clock to slowly usher our new 1-pound, 4-ounce son, Noah (now 15 years old), into the world.
Financial Domino Effects
This was an incredibly stressful time in our lives. Of all the things that burdened us, one of the most memorable was the nearly $5,000 invoice we received for a specific service. With no clue how we would pay this, I finally worked up the courage to pick up the phone and call the number on the invoice. The provider was demanding immediate payment before sending the bill to collections.
Me? Collections? But I’m the good guy, right? People should be reaching out to care for me. What just happened? After days of multiple information exchanges between me, the billing office and my insurance carrier, we finally figured it out—all charges were to be covered by insurance.
While our care through this time was generally very good, this unexpected charge put a cloud over the provider who lacked the proper information—despite a 120-day inpatient stay. Why did the provider send our bill to collections without contacting us? Where was the disconnect? Does this still happen today?
Fast Forward 15 Years to Smarter Billing and Collections
Sadly, this is not an isolated incident. Everyone knows a person with a similar story. But what if this patient billing story could be different? What if instead of multiple collection agency invoices demanding payment, I had been contacted early in the process? Or better yet, what if everything had occurred behind the scenes between provider and payor?
Technology advancements have narrowed the data gap that created these and other tensions for patients, providers and insurance carriers. Health care providers today can better serve their patients and communities through technology. The systems required to instantly supply insurance information and ensure patient-friendly billing are now available. It’s a matter of awareness and investment. Two key technology strategies are rapidly emerging to make collection letters and calls a thing of the past.
Real-Time Insurance Discovery
Insurance discovery solutions help providers find hidden insurance coverage for patients up front versus after the fact. Especially in emergency or self-pay situations, patients may have coverage the provider doesn’t know about. Finding coverage provides a tremendous boost to patient satisfaction and financial engagement.
For providers, finding and securing coverage early in the encounter helps billing teams circumvent months of patient statement and collection efforts. Operational costs are reduced and payor reimbursement is hastened. Best practices are rapidly emerging on how to incorporate real-time insurance discovery within patient registration and billing workflows.
Payment Likelihood Determinations
Where insurance coverage can’t be found or high deductibles result in exorbitant patient financial responsibilities, checking “payability” becomes crucial. Patients with minimal cash reserves or low propensity to pay can be moved to charity care, Medicaid, or account write-off. Families likely to qualify for financial assistance are also quickly identified by using payment likelihood applications.
Billers and collectors are more efficient and effective without damaging patient relations or community reputation. It is often a smarter long-term decision to write off patient balances in those cases where personal bankruptcy is only one medical bill away.
Proactive financial engagement, insurance discovery and smart collections are in the early stages in healthcare. However, provider organizations that embrace more patient-friendly billing strategies can significantly promote patient satisfaction and long-term community benefits.
Ted Williams has been a featured presenter at regional and national EMS conferences, including the state medical associations, ambulance networks, and technology user group conferences. Williams is a founder of Payor Logic, a national provider of healthcare revenue cycle solutions.
“EMS and Ambulance services are integral to the healthcare fabric of our communities, so it is essential that our reimbursement is not outstripped by the costs of providing service. As an unsubsidized local provider, we rely on the American Ambulance Association’s efforts to ensure Medicare payments are sufficient to allow us to continue serving our communities.”
Justin Grohs, Operations Manager
Great Falls Emergency Services
Great Falls, MT
Member, American Ambulance Association Government Affairs Committee