1 / 26

Alternative EMS Deployment Options ---------------------

Alternative EMS Deployment Options --------------------- Prepared for the City of Milwaukee Budget and Management Division . Jessica Gartner Teague Harvey Shaun Hernandez Jason Kramer Alex Marach Jason Myatt. Introduction. Current Environment

nan
Download Presentation

Alternative EMS Deployment Options ---------------------

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Alternative EMS Deployment Options --------------------- Prepared for theCity of Milwaukee Budget and Management Division  Jessica Gartner Teague Harvey Shaun Hernandez Jason Kramer Alex Marach Jason Myatt

  2. Introduction • Current Environment • State of Wisconsin’s 2011-13 biennial budget • 4.5 percent decrease in intergovernmental revenue for the City of Milwaukee • Property tax levy freeze on municipalities • Need for additional sources of revenue and enhanced efficacy of service delivery

  3. Overview: EMS care in Milwaukee • Provided through a public-private partnership • Milwaukee Fire Department (MFD) responds to more serious emergency calls with its 12 med units • Four privately owned ambulance services respond to calls involving non-life threatening situations • Potential source of revenue gains and/or cost reductions

  4. Policy objectives • Maximize net fiscal effect • Maintain quality of service • Ease of implementation • Public perception of EMS response • MFD and privates are at the same scene about 50,000 times per year (out of 93,383 calls)

  5. Overview: EMS dispatch • Two levels of emergency medical services defined by Wisconsin Administrative Code • Basic Life Support (BLS) • Advanced Life Support (ALS) • MFD Dispatch divides EMS calls into three tiers • BLS-Private(lowest severity) • BLS-MFD (moderate severity) • ALS (highest severity)

  6. BLS-Private NOTE: Private companies do not pay for dispatch services

  7. BLS-MFD

  8. ALS

  9. Capacity for EMS care • EMS personnel work 24-hour shifts • Capacity: Amount of time EMS personnel can be in service. • Current in-service time is just over 4 hours per med unit per day • We analyze capacity of 6 and 8 hrs/day. • Based on: • Quality of care • Current run times and standards

  10. Data sources • MFD Dispatch Data • All MFD unit dispatches from March 1, 2009, to February 14, 2011 • Includes information on unit status changes and responses (dispatched, en route, on scene, etc) • Accountability in Management (AIM) Report • Private provider dispatch data • Includes number of private calls for 2011

  11. Policy Options for MFD • Charge dispatch fee • Transport all ALS-Downgrades • Transport all ALS-Downgrades + some BLS-MFD calls • Transport all BLS-MFD +ALS calls

  12. Policy Option #1 • MFD charges a dispatch fee to private providers • MFD charges a $21 cost-recovery fee to the private providers for the dispatch services it currently provides • Fee based on (total dispatch costs) / (# of calls dispatched)

  13. Analysis of Policy Option #1 • Net revenue increase of $1,706,000 • Based on (dispatch fee) x (calls dispatched to privates)

  14. Transport status quo • MFD transports about 12,000 calls yearly • About 3,400 ALS-Downgrades transported by private ambulance companies • About 18,000 BLS-MFD-Private transports

  15. Policy Option #2 • MFD transports all ALS-Downgrade calls • MFD begins transporting all of the calls it responds to as ALS calls reclassified on-scene as BLS calls • These calls currently turned over to private providers for transports.

  16. Revenue generated per transport • $297.45 per transport on average • MFD bills more than is collected • Due to non-payment • Due to fixed reimbursement amounts

  17. Analysis of Policy Option #2 • Net revenue increase of $1,024,000 • Based on (per transport revenue) x (added transports) Analysis of Policy Option #1 and #2 • Net revenue increase of $2,558,000 • Based on (Option #2 net revenue) + (revised Option #1 net revenue) • NOTE: Revenue from dispatch fee is decreased due to fewer calls being sent to private companies

  18. Policy Option #3 • MFD transports ALS-Downgrades and some BLS-MFD calls, without adding personnel or equipment

  19. Analysis of Policy Option #3 • Net revenue increase of $2,396,000 (6-hr. capacity) • Net revenue increase of $4,171,000 (8-hr. capacity) • Based on (per transport revenue) x (added transports) NOTE: Capacity assumption impacts estimate of the number of additional calls MFD can handle

  20. Analysis of Policy Option #1 and #3 • Net revenue increase of $3,699,000 (6-hr. capacity) • Net revenue increase of $5,175,000 (8-hr. capacity) • Based on (Option #3 net revenue) + (revised Option #1 net revenue) • NOTE: Revenue from dispatch fee is decreased due to fewer calls being sent to private companies

  21. Policy Option #4 • MFD transports all BLS-MFD and ALS calls • Would need to hire additional EMS personnel and purchase additional equipment (4 or 9 med units)

  22. Analysis of Policy Option #4 • Net revenue increase of $1,625,000 (6-hr. capacity) • Requires 9 new med units and necessary personnel. • $524,000 annually per med unit. • Net revenue increase of $4,245,000 (8-hr. capacity) • Requires 4 new med units and necessary personnel. • Based on (per transport revenue) x (added transports)

  23. Analysis of Policy Option #1 and #4 • Net revenue increase of $2,265,000 (6-hr. capacity) • Net revenue increase of $4,885,000 (8-hr. capacity) • Based on (Option #4 net revenue) + (revised Option #1 net revenue) • NOTE: Revenue from dispatch fee is decreased due to fewer calls being sent to private companies

  24. Recommendations • Adopt Options #1 & #3 • MFD transports ALS downgrades and some BLS-MFD calls, without adding personnel or equipment • Implement a dispatch fee • Reexamine call to transport ratio and capacity efficiency issues • Net revenue increase of $3,699,000 (6-hr. capacity) • Net revenue increase of $5,175,000 (8-hr. capacity)

  25. Implementation • Change dispatch methodology from closest first, to capacity sensitive dispatching • Slow, methodological scale-up of additional transports • Allows determination of actual MFD capacity • Manages risk of overloading med units and personnel • Determine best methods for maximizing capacity • Utilize feedback from personnel • Avoid personnel burnout • Monitor response times

  26. Questions?Thank you!

More Related