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How Much Does EMS First Response Really Cost??

Learn about different economic models to determine the cost of EMS first response including methods like percentage of budget, unit hour cost, and tax-based approaches. Understand pros and cons to make informed decisions.

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How Much Does EMS First Response Really Cost??

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  1. How Much Does EMS First ResponseReally Cost?? ‘Economic Modeling 101’ Presenter: Matt Zavadsky, MHA EMS Director, Volusia County Florida Adjunct Faculty, University of Central Florida College of Health and Public Affairs

  2. Why is this Important? • Increasing budgetary constraints • Need to justify and/or benchmark against others or self over time • Recent research questioning value of pre-hospital ALS • OPALs Study - 2004

  3. Why is this Important? • Inter-jurisdictional issues • Mutual Aid, Automatic Aid • Contract for services • Inter-agency considerations • Fees for First Response to slow ambulance response times?

  4. Models Available... • Federal Emergency Management Agency Fee Schedule • Percent of Budget • By Incident • By Time on Task • Cost per Response • Fully Allocated • Marginal

  5. Models Available... Glad to be in FLORIDA • Cost per Unit Hour • Fully Allocated • Marginal

  6. “FEMA Model” • Fee schedule based on apparatus costs + actual personnel costs • Typical call = $37.50 • $35 {engine} + (2 {people} X $20/hour) X 0.50 hours • PROS: • All agencies accept this rate for reimbursement already • CONS: • Some feel this is underestimated and only accepted because nothing else is offered

  7. Why Men Should NotBaby Sit

  8. Percent of Budget Method • Percentage of time and/or resources used compared to the agency total budget • % of time on calls • X the agency’s total budget • PROS: • Compensates for ‘opportunity cost’ • CONS: • Difficult calculations • Rewards inefficiency

  9. Percent of Budget MethodIncident - Based

  10. Percent of Budget MethodTime - Based Time Available = Units x Hours on Duty 5 x 8,760 = 43,800

  11. Tax Based Method(a.k.a. - Insurance Model) • Cost based on the ad valorem millage for the contracted area • PROS: • Covers full costs of coverage (cost of readiness) • CONS: • Can only be used for sole response contracts • Negates cost shifting for areas with lower property values • Extremely difficult to determine reciprocal value in a municipal district without specific fire millage

  12. Tax Based Method(a.k.a. - Insurance Model)

  13. Unit Hour Cost Method • Total hours primary response units are available for calls • 1 unit 24 x 7 = 8,760 hours • 5 units on duty = 43,800 Unit Hours • Budget = $5,100,000 • $5.1 million / 43,800 = $116.44 per unit hour

  14. Unit Hour Cost Method • For an EMS Call: • 1 Unit X 0.40 hour = $46.40 • For a Structure Fire: • 3 units X 3 hours = $1,047.96 • PROS: • Easy to calculate • Allows for multiple unit reimbursement • Allows for time specific reimbursement • CONS: • Some feel $ is too low

  15. Is Your Brain Still Here??

  16. Cost per Incident Method • Total Budget / Total Incidents • $5,100,000 / 5,233 = $974.58 per incident • PROS: • Super easy to calculate • CONS: • No factor based on type of incident and resource use • 20 minute - single unit EMS vs. 5 unit 4 hour fire • Rewards inefficiency • Higher budget and few calls = high cost/incident

  17. Cost per Incident Method • “Normalize” based on countywide stats

  18. Summary Models...

  19. Summary Models...

  20. Examples from YOU...

  21. Things are Not AlwaysWhat they Appear... Be diligent in any cost analysis

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