EMS “Frequent Flyer” Abuse

A recent article at JEMS.com on EMS System Abuse told of examples of “frequent flyers” (that is non-emergency patients requesting multiple transports by EMS agencies on a fairly regular basis) many of which would be amusing if they weren’t so sad. The author offered up that while it is a serious practice of abuse by the public, it is also a problem with no solution. Perhaps, however, that is somewhat of an over-simplification as the article did suggest after all that if we could first cure poverty, homelessness, mental illness, substance abuse, domestic abuse, lack of primary care and education then we could perhaps eliminate the indiscriminate use of emergency services.

From a quick review of the solutions implemented in the past by multiple agencies to avoid abuses involving non-emergency transport including taxi vouchers, bus passes, referrals to physician offices, etc. which have been implemented and then often abandoned it is clear that the problem is not easily solved.  The fear of litigation for under estimating the urgency of a call is a strong motivator to permit these abuses, but that also comes at a cost.

While it may be easy for those who are not responsible for managing the budget to say it simply can’t be solved, can agency management continue to utilize resources in an inefficient manner indefinitely by weighing the cost of a potential lawsuit as the cost justification? How does a High-Performance EMS agency balance the unfettered demand for transport with optimization of services to control costs? We’d like to hear about your experiences or insights.

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High Performance Emergency Medical Services (HP-EMS) systems provide effective clinical care promoting positive patient outcomes and community wellness while maintaining a focus on improving economic efficiency of the system.  This site is dedicated as a community seeking to increase agency performance by promoting useful information regarding the developing trends and improvements in the efficiency of delivering basic and advanced medical care in the field.

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Comments
Jeffrey Hammerstein
Stop Dissing Response Times and Start Dissecting the Argument
I think that the position someone takes on this issue depends entirely on the circumstances of the particular EMS system they have in mind when they consider the question. If we're comparing a 7 minute response time to a 70 minute response time (or infinite as mentioned above), then of course it matters. That's a…
2015-07-03 11:44:45
Dave Shrader
Stop Dissing Response Times and Start Dissecting the Argument
I had meetings recently with a client in an underserved County. They have multiple tax supported volunteer organizations, and a City FD as EMS providers. The system is totally Balkanized with each agency doing it’s own thing. One agency failed to even respond to 66% of its calls last year. So, 66% of the time,…
2015-07-03 08:08:44
Matt Zavadsky
What Higher EMS Pay Requires
This article is spot on - the rapidly changing healthcare finance environment is a game changer for us - IF, and ONLY IF, we can prove that we bring value to the payer... Does our care make a difference in the patient's experience of care, outcome and cost of care... By assessing our patient satisfaction,…
2015-06-17 08:38:01
Steven Lichtenberg
What Higher EMS Pay Requires
The biggest issue in pay scales is one you hit on directly. Payment for service rendered is solely based on transports. Refusals/DNR/DOA etc are not reimbursed. Once Medicare determines that we are in fact medical professionals and not "ambulance drivers" and pays for care rendered we have a chance. Community paramedicine is one mechanism for…
2015-06-16 21:47:53
daleloberger
What Higher EMS Pay Requires
Thank you for making the comment, Kim. I suspect you may have missed my meaning in that statement though. The passionate folks in EMS are some of the hardest working people I know. My complaint is certainly not that "we" don't put enough into our jobs to deserve better pay, it is that we must…
2015-06-16 18:13:18

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