Trend Watch 2018: Emerging Issues in EMS

Experts weigh in on budget challenges, staffing struggles and growing opioid epidemic

By Medline Newsroom Staff | December 14, 2017

One million. That’s how many more calls EMS providers responded to in 2016 compared to just two years before, according to the National Run Survey, but a common theme for most fire departments and ambulance providers is the struggle to sustain operations at their current level. Recently, firefighters, paramedics and EMTs gathered at Medline for the first-ever EMS Advisory Board to share the following concerns and challenges they’re preparing for in 2018.

“Many of the problems in the EMS community are pretty universal, but the impact on fire departments and ambulance services can differ depending on that state’s laws and funding structure,” says Rhonda Baliff, post-acute care divisional sales manager, Medline, and a former volunteer EMT. “It’s important to understand these issues so we can identify the best solutions that ultimately lead to better care for the patient in a medical emergency.”

Innovative Healthcare Initiatives

A Government Accountability Office study found Medicare paid six percent below the average cost per transport of ground ambulance services. Through mobile integrated health – community paramedicine, EMS providers also have the ability to address unnecessary hospital visits and ease the burden on their budgets. More departments are testing this innovative approach to healthcare, allowing EMTs and paramedics to respond to homes of patients with chronic disease management needs or even assist with post-hospital discharges to reduce readmissions.

In Colorado, West Metro Fire Rescue, the largest fire district and largest fire-based EMS provider in that state, is putting together a pilot program. “This public private partnership that we’re developing will allow us to provide care in their home, and be able to get reimbursed through insurance companies or through Medicare or Medicaid,” said West Metro Fire Chief Don Lombardi. “We think that about a quarter of our 911 calls that we start off with will be able to go to this new mobile integrated healthcare. I think we should be able to save millions of dollars in healthcare costs just for our community.”

Reduction and Consolidation

More than half of EMS providers say retaining EMTs and paramedics is a problem, with those in rural areas having the greatest difficulty in keeping staff to keep their communities safe, according to a Rural Health and Research Policies Survey. A national EMS assessment found one-third of the states that provided information acknowledged that the majority of their EMS agencies with transport capability are considered to be volunteer. These same agencies that are relying on fundraising and reimbursements are battling an industry average denial rate of 30 percent.

“The value of EMS to the communities is great, but the resources and the funding continue to shrink and diminish,” said Marc Cohen, executive director of the Wisconsin EMS Association. “What we’re seeing across the country is that services are consolidating and cross credentialing in order to maintain service to their communities.”

With most volunteer and even paid providers having a background solely in administering medical services, billing can be an afterthought leaving many departments struggling to get the proper reimbursements to fund their operations. Through a partnership with Fire Recovery USA, Medline is able to structure a solution that meets the financial requirements of EMS providers big and small. Fire Recovery USA’s proprietary systems and software allow fire departments and ambulance companies to efficiently and effortlessly bill for services.

Overcoming the Opioid Epidemic

The CDC reports more than half of the people who died of opioid overdoses in the second half of 2016 tested positive for fentanyl, a lethal opioid that is 30-50 times more powerful than heroin. This growing drug epidemic has prompted the CDC and the Drug Enforcement Agency (DEA) to issue guidelines for EMS workers regarding safe practices and use of personal protective equipment.

“We want to make sure the EMT or the medic is protected in giving the care. There could be indirect exposure,” said Baliff. “Many times, paramedics, EMTs and firefighters are first on the scene of an overdose and it can be completely unsecured. So we want to make sure we proactively have the resources for our caregivers and that they’re protected no matter the environment.”

To view a video highlighting some of the trends in EMS to watch for in 2018, visit

For more information about Medline’s offerings for EMS providers, visit To read more about the growing issues with funding and staffing in EMS, Check out “The Voices of Healthcare” blog at To stay up to date on the latest trends in EMS, follow @MedlineEMS on Twitter.

Interview opportunities to discuss financial issues and personal protective equipment concerns for EMS providers are available with Rhonda Baliff, West Metro Fire Chief Don Lombardi and Marc Cohen.

About Medline

Medline is a global manufacturer and distributor serving the health care industry with medical supplies and clinical solutions that help customers achieve both clinical and financial success. Headquartered in Northfield, Ill., the company offers 350,000+ medical devices and support services through more than 1,200 direct sales representatives who are dedicated points of contact for customers across the continuum of care.  For more information on Medline, go to or to connect with Medline on its social media channels.



Medline Newsroom Staff

Medline Newsroom Staff

Medline's newsroom staff researches and reports on the latest news and trends in healthcare.

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