Tag: Michigan

MI | Opioid Treatment Ecosystems Save Lives

From Second Wave Michigan, “Leading the nation, Michigan’s Opioid Treatment Ecosystems save lives through holistic model,” feating AAA member Emergent  Health Partners

Often the first on the scene, emergency medical technicians (EMTs) working within the Opioid Treatment Ecosystem do more than administer naloxone, CPR, and ambulance transport. In Monroe County, Opioid Treatment Ecosystem initiative partner Emergent Health takes a team approach to overdose patients that includes law enforcement, medical providers, and mental health services.

“Unfortunately, opiate abuse is an addiction disease that’s a tough habit for people to overcome. We do see some people on a lot more frequent basis than we’d like,” says Karl Rock, vice president of south central operations for Emergent Health, which oversees Monroe Community Ambulance and Jackson Community Ambulance. “It is really [impacting] everybody, one of those diseases that spans all demographics, ages, race, economic status, everything.”

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Celebrating West Michigan EMS workers

From  Fox 17 West Michigan

GRAND RAPIDS, MICH. — This week marks the 46th annual National EMS Week and Life EMS of West Michigan is celebrating their nearly 600 workers.

This year’s theme is “Ready for Today; Prepared for Tomorrow” a timely message amid the current COVID-19 pandemic, and while the celebrations may look slightly different this year they’re still making things special.

EMS week dates back to 1974 and it was started by President Gerald Ford to celebrate the work EMS practitioners do for our nations communities.

Every year as part of the national recognition Life EMS recognizes a ‘Star of Life’ through the American Ambulance Association, whom they send to Washington, DC to be recognized. This year that’s not possible but they’re doing what they can to celebrate their recipient Mark De Graaf locally and virtually.

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Detroit News | Op-Ed: Don’t leave EMS behind in virus recovery

Don’t miss this  exceptional editorial   from Ron Slagell, CEO of Emergent Health, proud AAA member, and past president of the Michigan Association

As the COVID-19 relief funding becomes available, we ask our state leaders to use some of these funds to ensure we are paid for our work. Even before this crisis, the Medicaid reimbursement rate for ambulance services was far too low. In fact, there has not been a legislative increase in Medicaid rates in more than 20 years. Michigan’s ambulance providers are asking for a much-needed Medicaid rate increase to help us address skyrocketing costs,  if only temporarily to deal with this crisis.

NBC Nightly News | EMS workers speak out from front lines of coronavirus crisis

On April 15, NBC nightly news profiled the front line COVID-19 response in a segment featuring members Acadian Ambulance, Empress EMS, Medstar (MI), and the Fire Department of New York. Thank you to Lester Holt and Stephanie Gosk for sharing mobile healthcare’s value and perspective during the pandemic.


Emergency responders, used to trauma and danger, say it’s impossible to get used to their new reality during the coronavirus pandemic. “You’re coming to work to deal with death all day,” one New York EMS worker says.

40 Under 40: Brian Walls (Huron Valley Ambulance – Ann Arbor, MI)

40 Under 40 nominees were selected based on their contributions to the American Ambulance Association, their employer, state ambulance association, other professional associations, and/or the EMS profession.
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Brian Walls
Paramedic Supervisor
Huron Valley Ambulance
Ann Arbor, MI

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LinkedIn
Nominated by: Paul Hood (Huron Valley Ambulance – Ann Arbor, MI)
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Biography:

Brian Walls has worked at Huron Valley Ambulance (HVA) for 15 years working his way up from Wheelchair Van Driver to Paramedic Supervisor. Brian currently serves as a Senior Critical Care Paramedic, part-time Paramedic Supervisor, and holds the roles of Medical Officer and Coordinator for the Washtenaw County Hazmat, Special Pathogens, and Technical Rescue teams at HVA. Through Brian’s responsibilities, he has had both a local and national impact on new protocols and standards for hazmat and special pathogens. Specifically, Brian assists with public health preparedness and acts as an EMS liaison to regional healthcare partners as well as regional and state health departments.

Brian has written hazmat policy, procedures, and the Special Pathogens Response Guidebook for HVA’s special response team that has been adopted by the State of Michigan. Additionally, Brian’s leadership on the Technical Rescue Team has created an invaluable resource to surrounding communities for all aspects of technical rescue response by updating and creating state treatment protocols and medical operations.

A lifelong resident of southern Michigan, Brian graduated with a bachelor’s degree in Public Safety in 2013. Brian is a volunteer firefighter in Milan, Michigan. Brian and his wife recently welcomed their first child, Riley Ann.
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Reason for Nomination:

Brian is an outgoing and personable individual who is well liked and respected by all. Brian wears many hats at HVA which includes functioning as a Senior Critical Care Paramedic, part-time Road Supervisor, and Medical Officer and Coordinator for the Technical Rescue Team and the Hazmat teams. Brian actively works in his various roles to raise the bar in EMS. Brian puts 110% into everything he does and always maintains a positive demeanor and professional attitude. Despite being so busy, Brian is always very caring, compassionate, and thorough while performing all his duties.

Recently, Brian was tasked to prepare and establish a Special Pathogens Response Team, specifically for Ebola patient transfers. Brian researched, attended multiple trainings out of state at the National Ebola Training Education Center (NETEC) and the Center for Domestic Preparedness for Highly Infectious Diseases, and visited fire departments who transported confirmed Ebola patients in 2014.

Brian continued researching for over two years, training with his team several times a month, while obtaining feedback to develop procedures and guidelines for Washtenaw County. This resulted in Brian writing a copyrighted guidebook called, The Special Pathogens Response Guidebook that guides EMS agencies through an entire patient transfer from start to finish. This includes pre-incident planning, donning and doffing, patient transfer, communications, hand off, waste disposal, disinfection, and emergency procedures. In addition to writing the response guidebook for EMS, Brian worked with his team and the local treatment center to create a custom designed Highly Infectious Disease Unit (ambulance) that improves the safety of his crew while in Hazmat suits. This custom-built ambulance improves ventilation and temperature control, thus increasing the time crew members can be in Hazmat suits. The specially designed ambulance also minimizes the amount of hazardous material waste that needs to be collected by our local treatment center and reduces the amount of time it takes to disinfect and place the ambulance back in service.

Finally, Brian reached out to the NETEC to schedule a site assessment for EMS, which it had never done before. NETEC used HVA’s Special Pathogens Response Team and Guidebook as a pilot to establish their own site assessment algorithm to help EMS programs with a special pathogens transport around the nation.

Through his hard work and dedication, Brian has expanded HVA’s response area from only transporting in a couple counties of Michigan, to becoming the backup agency to assist all EMS agencies for the entire state of Michigan. Brian continues to work with Michigan state and local health departments in special pathogens response and preparedness.

Brian’s attention to detail and dedication to positively impact policy change are what makes him stand out in EMS.

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View all of the 2020 Mobile Healthcare 40 Under 40 Honorees

Senator Debbie Stabenow Named Legislator of the Year

For Immediate Release

Senator Debbie Stabenow To Receive Highest Legislative Honor From American Ambulance Association

To Be Recognized As AAA Legislator of the Year

Contact
Amanda Riordan
703-610-9018
ariordan@ambulance.org
www.ambulance.org

Washington, DC – The American Ambulance Association (AAA) will honor Senator Debbie Stabenow of Michigan with its Legislator of the Year Award in appreciation of her advocacy for emergency medical services.

Senator Stabenow is invited to receive this honor at the AAA’s Annual Stars of Life Recognition Ceremony on June 11 in Washington, D.C.

The Stars of Life program celebrates the contributions of ambulance professionals who have gone above and beyond the call of duty in service to their communities or the EMS profession. The Stars of Life program pays tribute to the dedication of these heroes while shining light on the critical role EMS plays in our healthcare infrastructure. This year, 100 EMS professionals will be honored as 2018 Stars of Life. In addition to Senator Stabenow’s recognition as 2018 Legislator of the Year, 34 United States Senators and Representatives will receive Legislative Recognition Awards for their support of ambulance services.

Senator Stabenow was selected for the Legislator of the Year Award in thanks for leading the effort in the United States Senate that secured a five-year extension of the Medicare ambulance temporary add-on increases of 2% urban and 3% urban and the super rural bonus payment. Senator Stabenow also ensured that other key provisions for the industry were included in the passage of the Bipartisan Budget Act of 2018. Senator Stabenow continues to go above and beyond to ensure that EMS in Michigan and across the country, receive sustainable reimbursement.

AAA President Mark Postma notes, “Senator Stabenow has been a trusted advocate for health care and emergency medical services, both in Michigan and across our country. The AAA is proud to present her with the distinction of Legislator of the Year Award.”

Elected to the U.S. Senate in 2000, Senator Stabenow is the Ranking Member of the Senate Finance Subcommittee on Health Care, Chair of the Democratic Policy and Communications Center, and Co-Chair of the Senate Great Lakes Task Force, and bipartisan Senate Manufacturing Caucus.

In recognition of her ongoing service to the ambulance services of the United States, AAA is proud to call Senator Stabenow our Legislator of the Year.

# # #

About the American Ambulance Association

Founded in 1979, the AAA represents hundreds of ambulance services across the United States that participate in emergency and nonemergency care and medical transportation. The Association serves as a voice and clearinghouse for ambulance services, and views prehospital care not only as a public service, but also as an essential part of the total public health care system.

AAA Stars of Life

The Stars of Life program celebrates the contributions of ambulance professionals who have gone above and beyond the call of duty in service to their communities or the EMS profession. Stars of Life honors the dedication of these heroes while shining light on the critical role EMS plays in our healthcare infrastructure. This year, 100 EMS professionals will be honored as the 2018 Stars of Life. Meet the stars at www.stars.ambulance.org.

AAA Mission Statement

The mission of the American Ambulance Association is to promote health care policies that ensure excellence in the ambulance services industry and provide research, education, and communications programs to enable its members to effectively address the needs of the communities they serve.

Congrats to CAAS Accreditations & Recerts

Congratulations to the AAA members who received Commission on the Accreditation of Ambulance Services (CAAS) accreditation or reaccreditation in November and December!

New certifications

  • Superior Air-Ground Ambulance (Elmhurst, IL)

Recertifications

  • Ambucare (Bremen, GA)
  • American Medical Response Central Mississippi (Jackson, MS)
  • American Medical Response, Los Angeles (Irwindale, CA)
  • American Medical Response, San Diego (San Diego, CA)
  • American Medical Response of West Michigan (Grand Rapids, MI)
  • American Medical Response South Mississippi (Gulfport, MS)
  • Lifeguard Ambulance Service (Milton, FL)
  • Metro West Ambulance (Hillsboro, OR)
  • Richmond Ambulance Authority (Richmond, VA)

2017 J. Walter Schaefer Award

Contact: Jessica Marvin
Telephone: 703-610-9018
Email: jmarvin@ambulance.org

AMERICAN AMBULANCE ASSOCIATION HONORS MARK MEIJER WITH THE 2017 J. WALTER SCHAEFER AWARD

Washington, DC– McLean, VA — The American Ambulance Association (AAA) is proud to award Mark Meijer with the 2017 J. Walter Schaefer Award.

The J. Walter Schaefer Award is given annually to an individual whose work in EMS has contributed positively to the advancement of the industry as a whole. Mark has achieved this distinction through dedication and service in his role as President of the Michigan Ambulance Association.

AAA President Mark Postma noted, “Mark has worked tirelessly to elevate the Michigan Ambulance Association and its members to national prominence. We are proud to celebrate his achievements to the communities he serves by presenting him with the J. Walter Schaefer Award for 2017.”

Mr. Meijer will be presented with the J. Walter Schaefer Award at the AAA Annual Conference and Tradeshow Membership Meeting on Tuesday, November 14, 2017. This event is the premier event for leaders in the ambulance industry, featuring world-class education, networking, and cutting-edge technology.

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About the American Ambulance Association
Founded in 1979, the AAA represents hundreds of ambulance services across the United States that participate in emergency and nonemergency care and medical transportation. The Association serves as a voice and clearinghouse for ambulance services, and views prehospital care not only as a public service, but also as an essential part of the total public health care system.

AAA Mission Statement
The mission of the American Ambulance Association is to promote health care policies that ensure excellence in the ambulance services industry and provide research, education, and communications programs to enable its members to effectively address the needs of the communities they serve.

2017 AAA Award Winners Announced

The American Ambulance Association is proud to announce this year’s award winners. Awards will be presented at the AAA Annual Conference & Trade Show Membership Meeting on Tuesday, November 14, 2017. Please join us in congratulating this year’s winners!

J. Walter Schaeffer Award

Mark Meijer, Life EMS Ambulance
The J. Walter Schaeffer Award is given annually to an individual whose work in EMS has contributed positively to the advancement of the industry as a whole. Mark Meijer has achieved this through his many years of commitment and service to the ambulance industry.

Robert L. Forbuss Lifetime Achievement Award

Fred Della Valle, AMR Connecticut
The Robert L. Forbuss Lifetime Achievement Award is named in honor of the first Executive Director of the American Ambulance Association. It recognizes a volunteer leader who has made a significant long-term impact on the association. Fred Della Valle has achieved this through his decades of service, commitment, and dedication to the AAA and its members.

President’s Award

Dr. John Russell, Cape County Private Ambulance
Paul Main, American Ambulance of Visalia
These awards are bestowed by the President to volunteer leaders who have shown commitment to the advancement of the AAA above and beyond the call of duty. This year, the two outstanding volunteers represent tireless work on behalf of the AAA. Dr. Russell is recognized for his ongoing support of AAA’s programs and leadership on clinical and ambulance service standards. Paul Main has achieved this honor for his dedication and service to AAA’s Government Affairs efforts.

Distinguished Service Award

Jamie Pafford-Gresham, Pafford EMS
Shawn Baird, Woodburn Ambulance Service
The American Ambulance Association is proud to award Jamie Pafford-Gresham and Shawn Baird with the 2017 Distinguished Service Awards. Jamie Pafford-Gresham and Shawn Baird have achieved this distinction through their dedication, passion, and commitment in support of AAA’s Legislative Priorities.

2017 Affiliate of the Year

REV
The American Ambulance Association (AAA) is proud to award REV with the 2017 Affiliate of the Year Award. REV has achieved this honor through their support of AAA’s programs and services including our 2017 Legislative Priorities.

EMS Partnership of the Year

James D. Green
National Institute of Occupational Safety and Health
Centers for Disease Control and Prevention
The EMS Partnership of the Year Award is given to an organization or individual whose collaboration with the AAA enhances educational programs, legislative priorities, and/or member benefits. James D. Green and NIOSH have achieved this honor through their commitment to ambulance vehicle and personnel safety standards.

EMS Innovation Award

Savvik Foundation
Savvik Foundation is honored with a special EMS Innovation Award for its commitment to supporting the future of emergency medical services through their grant program.

Congressman Fred Upton to Receive AAA Legislative Honor

Congressman Fred Upton to
Receive AAA Legislative Recognition Award

For Immediate Release
Contact:
Amanda Riordan
ariordan@ambulance.org
703-610-0264

Washington, DC, – The American Ambulance Association (AAA) will honor Congressman Fred Upton of Michigan with a Legislative Recognition Award in appreciation of his advocacy for emergency medical services.

Congressman Upton will be presented this award in June in Washington, DC by AAA’s Michigan Stars of Life—EMS personnel selected for their excellence and dedication. This year’s Stars from the Great Lakes State are Tracy Allen and Theresa Hartman of American Medical Response, Bridget Dickert of LifeCare Ambulance Service, Donald Brown III of Jackson Community Ambulance/Emergent Health Partners, and John Eilich III of Life EMS Ambulance.

Congressman Upton was selected for the Legislative Recognition Award for his long-standing support of ambulance services and ensuring proper reimbursement under the Medicare ambulance fee schedule.

AAA President Mark Postma notes, “Congressman Upton has been a trusted advocate for health care and emergency medical services, both in Oregon and across our country.”

Congressman Upton represents Michigan’s 6th congressional district and was first elected to Congress in 1986. He is the current Chair of the House Energy and Commerce Energy Subcommittee, as well as a member of the Bipartisan Encryption Working Group.

In appreciation of his ongoing service to the ambulance services of the United States, AAA is proud to honor Congressman Upton with a Legislative Recognition Award.

# # #

About the American Ambulance Association

Founded in 1979, the AAA represents hundreds of ambulance services across the United States that participate in emergency and nonemergency care and medical transportation. The Association serves as a voice and clearinghouse for ambulance services, and views prehospital care not only as a public service, but also as an essential part of the total public health care system.

AAA Stars of Life

The Stars of Life program celebrates the contributions of ambulance professionals who have gone above and beyond the call of duty in service to their communities or the EMS profession. Stars of Life honors the dedication of these heroes while shining light on the critical role EMS plays in our healthcare infrastructure. This year, 101 EMS professionals will be honored as the 2017 Stars of Life. Meet the stars at www.stars.ambulance.org.

AAA Mission Statement

The mission of the American Ambulance Association is to promote health care policies that ensure excellence in the ambulance services industry and provide research, education, and communications programs to enable its members to effectively address the needs of the communities they serve.

Senator Stabenow Receives AAA Legislative Honor

Senator Debbie Stabenow Receives
2017 AAA Legislative Recognition Award

For Immediate Release
Contact:
Amanda Riordan
ariordan@ambulance.org
703-610-0264

Washington, DC – The American Ambulance Association (AAA) will honor Senator Debbie Stabenow of Michigan with a Legislative Recognition Award in appreciation of her advocacy for emergency medical services.

Senator Stabenow will be presented the award in June in Washington, DC by AAA’s Michigan Stars of Life—EMS personnel selected for their excellence and dedication. This year’s Stars from the Great Lakes State are Tracy Allen of American Medical Response, Bridget Dickert of LifeCare Ambulance Service, Donald Brown III of Jackson Community Ambulance/Emergent Health Partners, John Eilich III of Life EMS Ambulance, and Theresa Hartman of American Medical Response.

Senator Stabenow was selected for the Legislative Recognition Award in thanks for her long-standing support of the Medicare ambulance temporary add-on increases and the super rural bonus payment, as well as co-sponsorship of Medicare ambulance relief and reform legislation.

AAA President Mark Postma notes, “Senator Stabenow has been a trusted advocate for health care and emergency medical services, both in Michigan and across our country. The AAA is proud to present her with the Legislative Recognition Award.”

Elected to the U.S. Senate in 2000, Senator Stabenow is the Ranking Member of the Senate Finance Subcommittee on Health Care, Chair of the Democratic Policy and Communications Committee, Co-Chair of the Senate Great Lakes Task Force, and Co-Chair of the bipartisan Senate Manufacturing Caucus.

# # #

About the American Ambulance Association

Founded in 1979, the AAA represents hundreds of ambulance services across the United States that participate in emergency and nonemergency care and medical transportation. The Association serves as a voice and clearinghouse for ambulance services, and views prehospital care not only as a public service, but also as an essential part of the total public health care system.

AAA Stars of Life

The Stars of Life program celebrates the contributions of ambulance professionals who have gone above and beyond the call of duty in service to their communities or the EMS profession. Stars of Life honors the dedication of these heroes while shining light on the critical role EMS plays in our healthcare infrastructure. This year, 101 EMS professionals will be honored as the 2017 Stars of Life. Meet the stars at www.stars.ambulance.org.

AAA Mission Statement

The mission of the American Ambulance Association is to promote health care policies that ensure excellence in the ambulance services industry and provide research, education, and communications programs to enable its members to effectively address the needs of the communities they serve.

2017 AAA Legislative Awards

Spotlight: Barbara Bachman, Emergent Health Partners

barbara-bachman-emergent-health-partnersBarbara Bachman
Chief Financial Officer, Emergent Health Partners
Alternate Director, AAA Board
Ann Arbor, MI

Please tell us a little about yourself.

I grew up in a small town in the Upper Peninsula of Michigan. The year I graduated from high school my parents relocated to North Carolina, so I have family in both places. I am married and have four grown children, two son-in-laws, and one granddaughter. I love to bake, and Christmas is my most favorite time of year. I make about 30 different kinds of cookies which I share with my employees.

How did you come to work in the industry? How long have you been involved?

I was in public accounting for over 20 years with a large regional firm and a Big 5 firm. I then moved on to be the controller at a company that managed about 30 physician clinics in the Flint, Michigan area. From there I went to a non-profit organization that was grant-funded by the state of Michigan. They offered workforce development and online courses for high school students. They were losing their funding so I applied for a job with Huron Valley Ambulance ( in 2004 and was selected to become the CFO.

What do you enjoy most about your job?

I enjoy the variety of challenges the job presents as I oversee finance, patient billing, IT, internal and external education, human resources, and our electronic charting software.

barbara-bachman-familyWhat is your biggest professional challenge?

My biggest professional challenge early on was gaining an understanding of the business. I actually sat through an EMT course and did several third rides including staying for full 24 hour shifts. Currently our biggest challenge is find qualified trained staff.

What is your typical day like?

Extremely busy with a multitude of meetings, questions from staff and managers, employee issues, and making sure everything is completed in a correct and timely manner.

How has participation in AAA membership and advocacy helped your organization?

Prior to being on the Board, I was on the Medicare Regulatory Committee which helps keep our organization informed about the latest happenings in reimbursement.

Musings on 2014 Medicare Payment Data…Part 2

Brian S. Werfel, AAA Medicare Consultant

Every year, the Centers for Medicare and Medicaid Services (CMS) releases data on Medicare payments for the preceding year. The 2015 Physician/Supplier Procedure Master File (PSP Master File) was released in late November 2015. This report contains information on all Part B and DME claims processed through the Medicare Common Working File with 2014 dates of service.

In last month’s post, I focused on total Medicare spending. This month, I want to shine the spotlight on Medicare’s payment for ambulance transports to and from dialysis.

It is no secret that the federal government has long viewed dialysis transports with suspicion. In 1994, the HHS Office of the Inspector General (OIG) issued a report citing dialysis transports as an area of concern. In a 2013 report, the OIG cited the dramatic increase in the volume of dialysis transports since the implementation of the Medicare Ambulance Fee Schedule as evidence that the Medicare ambulance benefit is vulnerable to fraud and abuse. Dialysis transports were also featured heavily in the OIG’s 2015 report on questionable billing practices.  A 2013 report by the Medicare Payment Advisory Commission (MedPAC) noted that the utilization of BLS non-emergency transports, dialysis in particular, had grown faster than the utilization of other ambulance levels of service.

The Numbers Don’t Lie…

According to statistics provided by the U.S. Department of Health and Human Services, the population of ESRD patients increased by 85% from 2002 to 2011. Over that same period of time, the OIG noted that the number of covered ambulance transports to and from dialysis increased by more than 269%. In other words, while the ESRD population has grown steadily over time, an increasing number of those patients are transported to and from their dialysis appointments by ambulance.

Medicare payment data confirms this. In 2007, Medicare paid a total of $445.8 million for dialysis transports. In 2014, Medicare paid $717.1 million for dialysis, an increase of 60.86%. The increase is even more dramatic when you consider that Congress mandated a permanent 10% reduction in Medicare’s payments for dialysis transports furnished on or after October 1, 2013. Without that reduction, Medicare’s payments for dialysis would have been closer to $800 million in 2014, an increase of nearly 80%. Over that same period of time, total Medicare payments for ambulance increased by only 27.08%.

Between 2007 and 2014, Medicare’s payments for ambulance services increased by approximately $1.06 billion, with dialysis transports accounting for $354 million. In other words, approximately one-third of the total increase in Medicare spending on ambulance is attributable to dialysis.

If you focus only on BLS non-emergency transports, the impact of dialysis is even more striking. In 2014, Medicare paid $1.139 million for BLS non-emergency transports (not counting mileage). This is almost essentially unchanged from the $1.131 million it spent in 2010. However, during that same period, payments for BLS non-emergency transports to dialysis increased from $513.7 million to $558.4 million. Put another way, if you remove transports for dialysis, Medicare’s payments for BLS non-emergency transports (and non-emergency transports in general) actually declined over the past five years.

In its 2013 report on ambulance utilization, the OIG noted that dialysis transports had increased to 19% of all covered ambulance transports in 2011, up from 9% in 2002. Note: in 2014, dialysis transports had dropped to 17.1% of all covered transports, suggesting we may start to see the pendulum shifting back a bit.

Our industry may ultimately look back on 2013 as a tipping point. That year marked the first time that the total volume of BLS non-emergency transports to and from dialysis exceeded the number of BLS non-emergency transports to or from places other than dialysis.

But They don’t Tell the Full Story Either…

While the overall trend has been upwards, the increase in dialysis transports is not a national phenomenon. Rather, this increase is largely confined to a handful of states.

As noted above, Medicare’s payments for dialysis transports increased by approximately $45 million between 2010 and 2014. During that same period, Medicare’s payments for dialysis transports in New Jersey increased by $50.7 million. You read that right, if you exclude New Jersey, total Medicare payments for dialysis would have declined nationwide. If you have ever asked: “Why was New Jersey selected to be one of the initial 3 states for the prior authorization program?”, you have your answer.

Other states that saw significant increases over that period include:

State 2010 Dialysis Payments 2013 (2014)

Dialysis Payments

California $87.7 million $106.0 million
Georgia $25.5 million $69.9 million (2014)
Illinois $13.5 million $19.3 million (2014)
Louisiana $4.0 million $6.4 million
Michigan $12.7 million $17.5 million
New York $23.5 million $30.1 million (2014)
South Carolina $51.1 million $62.4 million
Virginia $25.3 million $30.2 million
West Virginia $7.9 million $9.9 million (2014)

If your state is not one of the ones listed above, chances are Medicare’s payments for dialysis are lower today than they were 5 years ago. This includes a number of states and/or territories that, historically, have been recognized as having a so-called “dialysis problem.” For example, total payments for dialysis have declined in Texas from $86.7 million in 2010 (itself a significant reduction from 2007) down to $53.8 million in 2014. This is likely the result of ongoing enforcement efforts in the state, including a moratorium on the enrollment of new ambulance providers. Pennsylvania, also selected to be part of the initial prior authorization program, saw payments for dialysis transports drop to $39.2 million in 2014, down from $62.6 million in 2010.

As I look at this data, two thoughts come to mind. The first is that, to the extent you agree that there is a problem with dialysis transports (and I am one of those that does), it is clear that the problem is largely confined to a handful of states.

The second is that our overall perspective on our industry may need to change. Traditionally, we have viewed the industry through the prism of “emergency” vs. “non-emergency.” And there are valid operations reasons to distinguish between these two categories. However, I can’t help but wonder if that worldview isn’t overly simplistic these days. Maybe we need to start viewing our industry as having three components, emergencies, non-emergencies, and dialysis.


 

AAA members, submit a Medicare question to Brian! Not yet a member? Learn more.

Spotlight: Kim Godden

Kim Godden
Vice President of Legal and Government Relations
Superior Air-Ground Ambulance Service (Michigan, Indiana, Illinois)
Region 3 Alternate, American Ambulance Association Board
Elmhurst, IL

Tell us a little about yourself.

I grew up in Barlett, Illinois, a Chicago suburb. I received my BA in History and Political Science from Purdue University and my law degree from DePaul University College of Law.

After graduating from Purdue, I worked for the Illinois Attorney General’s Office while attending law school in the evening. While with the Attorney General’s office, I was an policy analyst/attorney for criminal justice and victims’ rights initiatives. During this time, I reviewed, drafted, and testified on various legislative and regulatory initiatives.

In 2007, I was able to bring this experience to the ambulance industry when I joined Superior. In addition to sitting on the AAA board, I also sit on the boards of the Illinois State Ambulance Association and the Indiana EMS Association. I also participate on the government affairs committee for the Michigan Association of Ambulance Services.

In addition to overseeing government relations and regulatory and compliance matters for Superior, I oversee the legal department which manages litigation, contracts, real estate and employment matters.

Kim with her family.
Kim with her family.

I have been married to my husband, Nick, for 16 years and we have two daughters, Hannah (8) and Amelia (6). As for hobbies, kids and work keep me busy, however, when I have a chance, I enjoy running and reading (not at the same time).

What do you enjoy most about your job?

I enjoy problem-solving and advocating for such an amazing industry. The ambulance industry is often overlooked and misunderstood. EMS providers are busy caring for patients, therefore, we rarely have time to create awareness and support for our industry – I get to beat the drum for private EMS!

What is your biggest professional challenge?

My biggest challenge is changing the perception that private industry isn’t as good or worthwhile as public agencies. There is a misconception that because a company is for-profit, their goals, mission, and level of compassion differ from those of a public or nonprofit entity. Superior employs over 2000 dedicated, devoted EMS professionals—whether caring for patients, working in dispatch, or managing the back office, our entire team is dedicated to bringing the best care and customer service to our patients.
[quote_right]Superior employs over 2000 dedicated, devoted EMS professionals—whether caring for patients, working in dispatch, or managing the back office, our entire team is dedicated to bringing the best care and customer service to our patients.[/quote_right]

What is your typical day like?

Every day is different due to travel and attendance at various meetings. On a typical day, I try to drop my daughters off at school at 8:30 and I am in the office by 9:15. Usually the day is filled with meetings and conference calls on a myriad of topics, with the constant interruption of emails that need attention and various “walk-ins” for legal consultation. No two days are the same, which I enjoy. I am usually home by 7:00 p.m., and after bedtime stories, I am back on the computer responding to the day’s emails or catching up on reading. My 2016 resolution is to unplug and try to leave work at work, but we all know that EMS is a 24-hour business, so I won’t be 100% successful and it will occasionally follow me home.

How has participation in AAA membership and advocacy helped your organization?

As we know, with advances in healthcare, people are living longer, and there is frequent need to move patients between nursing facilities and hospitals. We have also seen the advent for advanced level care for patients. Most inter-facility transports involve the discharge of a patient back to a nursing facility, or moving a patient from one facility to another for specialized care. Superior and our colleagues who provide these services are an important part of EMS and the overall continuum of care.

Our organization performs a high percentage of inter-facility transports, and being able to advocate and share the perspective of an agency who performs this discipline has been worthwhile not only to Superior, but to the industry as a whole. Being able to discuss with other providers our shared and differing challenges is important as we craft regulations for the future.

I enjoy working with my fellow board members and AAA staff. We don’t always agree, however we respect one another’s opinions and in the end, this leads to better policy and advocacy for our industry.


Explore AAA membership, or learn more about our advocacy for ambulance services across the country.

Spotlight: Patrick Hatch

Patrick Hatch
Paramedic
Life EMS
Grand Rapids, Michigan, USA

Can you please tell us a little about yourself?

Grand Rapids has always been my home. This city has transformed itself in the last 30 years, I love it here! I have a strong passion for music, specifically classic rock era, and I play guitar and perform in a cover band.

How did you come to work in the industry? How long have you been involved?

I became a paramedic in 1984 with the intention of becoming certified in criminal justice.

What do you enjoy most about your job?

I still like the high priority patients. I like to mentor and practice with particular attention to detail!

What is your biggest professional challenge?

I would like to see a structured tier of paramedics where the medic provider can obtain higher training in areas such as RSI; non-urgent cases such minor suture repair and pain management; and greater responsibility.

What is your typical day like?

It can vary from multiple back to back high acuity patients to relatively easy transports and encounters!

CMS Extends Ambulance Enrollment Moratoria

On July 25, 2015, CMS issued a notice extending the temporary moratorium for enrollment of new ambulance suppliers in the Texas counties of Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and Waller, as well as in Philadelphia and the surrounding counties of Bucks, Delaware, Montgomery (Pennsylvania), Burlington, Camden and Gloucester (New Jersey). This notice will appear in the Federal Register on July 28, 2015.