News & Updates

In cooperation with the American Ambulance Association, we and others have created a running compilation of local and national news stories relating to EMS delivery. Since January, 2021, over 1,800 news reports have been chronicled, with 49% highlighting the EMS staffing crisis, and 34% highlighting the funding crisis. Combined reports of staffing and/or funding account for 83% of the media reports! 96 reports cite EMS system closures/agencies departing communities, and 95% of the news articles reference staffing challenges, funding issues and response times.


Click below for an up to date list of these news stories, with links to the source documents.

Media Log as of 3-27-24 READ Only.xlsx

  • 29 Aug 2018 12:52 PM | AIMHI Admin (Administrator)

    Source Article | Download Research Report

    DALLAS – Aug. 28, 2018 – Heart attack patients given a different type of breathing tube by paramedics had better survival rates than those treated by traditional intubation breathing tube methods – findings that could potentially save more than 10,000 lives annually, researchers report.

    Only about 10 percent of people who suffer cardiac arrest outside hospital settings survive, and paramedics currently use both breathing tube techniques. By comparing the two in real-world situations, investigators were able to identify a 3 percent better survival rate for patients who received the laryngeal tube (LT) device on scene than those who received the standard intubation tube. The landmark study was the latest in a decades long series of investigations that have improved paramedic care after cardiac arrest.

    “When we first started working with EMS agencies in Dallas-Fort Worth in 2006, the survival rate from out-of-hospital cardiac arrest was about 4 percent. Because of the efforts we have made in measuring and improving CPR performance, the rate is now about 10 percent – more than double,” said Dr. Ahamed Idris, Professor of Emergency Medicine and Internal Medicine at UT Southwestern who led the North Texas arm of the study. “A further improvement of 3 percent because of better airway management translates into a survival rate of 13 percent, which is a relative 30 percent improvement in the DFW area.”

    The Pragmatic Airway Resuscitation Trial (PART) – funded by the National Heart, Lung, and Blood Institute, part of the National Institutes of Health – was the largest randomized clinical study of its kind. The new findings appear in JAMA.

    “This is the first randomized trial to show that a paramedic airway intervention can improve cardiac arrest survival. Based on these results, use of the newer LT devices could result in over 10,000 extra lives saved each year,” said first author Dr. Henry E. Wang, Vice Chair for Research in the Department of Emergency Medicine at UT Health Science Center at Houston.

    While identical to techniques used by doctors in the hospital, intubation in the prehospital setting is very difficult and fraught with errors, he said. Researchers believe that the benefits of the newer LT airway are due to its easier technique, leading to better blood flow and oxygen delivery. The LT devices allow first responders to continue uninterrupted CPR on cardiac arrest patients, with a potential to get thousands of additional cases into the nearest hospitals for further care.

    Firefighters, emergency medical technicians, and paramedics from 27 EMS agencies in several cities administered either traditional endotracheal intubation breathing tubes or an LT airway to about 3,000 adult patients with sudden cardiac arrest. The study, conducted by the Resuscitation Outcomes Consortium, tracked emergency care delivery in Dallas-Fort Worth; Birmingham, Alabama; Milwaukee; Pittsburgh; and Portland, Oregon, from December 2015 to November 2016.

    “Paramedics use both endotracheal intubation and laryngeal airway devices as standards of care for airway management and ventilation during out-of-hospital CPR. The study was done to determine if one of these standard of care techniques produced better outcomes than the other,” said Dr. Idris, Division Chief for Research in Emergency Medicine and Director of the Dallas-Fort Worth Center for Resuscitation Research sponsored by the National Institutes of Health, part of the North American Resuscitation Outcomes Consortium.

    A total of 18.3 percent in the LT group survived three days in the hospital compared with 15.4 percent of cardiac patients who were initially intubated. A total of 10.8 percent in the LT group survived to reach 10-day hospital survival compared with 8.1 percent in the intubation group.

    PART provides knowledge that will improve survival from cardiac arrest,” Dr. Idris added. “The results of this study will be used by EMS medical directors to inform their choice of airway technique that paramedics will use during CPR for cardiac arrest cases. Continuing careful measurement of performance and techniques is essential to improve outcomes from life-threatening illnesses.”

    Sudden cardiac arrest is most often caused by a heart attack, and delivery of oxygen to the lungs is a critical part of reviving a patient. More than 400,000 individuals are treated for out-of-hospital cardiac arrest each year, according to the American Heart Association.

    About UT Southwestern Medical Center

    UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes, and includes 22 members of the National Academy of Sciences, 16 members of the National Academy of Medicine, and 15 Howard Hughes Medical Institute Investigators. The faculty of more than 2,700 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in about 80 specialties to more than 105,000 hospitalized patients, nearly 370,000 emergency room cases, and oversee approximately 2.4 million outpatient visits a year.


  • 24 Aug 2018 11:55 AM | AIMHI Admin (Administrator)
    AIMHI's members are working hard to advance high performance EMS and mobile integrated healthcare. Don't miss any of the best practices, forward-thinking projects, or fun!


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    Contact Information Update

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    Thank you for your support!


  • 23 Aug 2018 8:48 AM | Matt Zavadsky (Administrator)

    This renewed emphasis could have an impact in states where they are using waivers to fund Medicaid payments for innovative EMS delivery models, such as MIH-CP, or alternate destination/treat and refer programs.

    A careful fiscal analysis will be needed to demonstrate downstream savings for Medicaid to assure at least budget neutrality.

    ------------------------------- 

    CMS vows to curb costs of state Medicaid demonstrations

    By Susannah Luthi  | August 22, 2018

    http://www.modernhealthcare.com/article/20180822/NEWS/180829959 

    The CMS is tightening its financial oversight of state Medicaid waiver demonstrations, the agency announced Wednesday in formal guidance emphasizing that the changes must be budget-neutral.

    Federal law requires Medicaid demonstrations to be budget-neutral, and the CMS can't disburse additional funds for the proposals. The CMS said in its guidance that it will run tighter analysis on demonstration costs to make sure states are meeting budget-neutrality

    The agency will not approve waivers that predict the federal government will incur additional costs. In a statement, CMS Administrator Seema Verma reiterated that federal Medicaid spending jumped by $100 billion from 2013 to 2016. That span includes the first years of Medicaid expansion, and the CMS mainly shoulders those costs.

    "Today's guidance is a comprehensive explanation of how CMS and our state partners can ensure that new demonstration projects can simultaneously promote Medicaid's objectives and keep federal spending under control," Verma said.

    Along with the guidance, the CMS unveiled a new monitoring tool it will require states to use for all their demonstrations. States will need to upload all the financial data of a given Medicaid demonstration into the tool, which will consolidate the numbers in one report to the agency. 

    On Tuesday, Verma and U.S. Comptroller General Gene Dodaro voiced concerns to a Senate panel that states sometimes use demonstrations to draw down additional funds. Dodaro also said states fall short when it comes to evaluating the demonstrations that are supposed to serve as test runs to inform new policy and noted that the CMS "continues to need written guidance on the methodologies for demonstrating budget neutrality."

    Dodaro told Senate lawmakers that a 2016 CMS policy that curbed states' ability to keep left-over funds from their demonstration or carry them forward to new demonstrations had saved the federal government nearly $63 billion in two years. But the policy did not affect all the "questionable methods" the Government Accountability Office had identified in how the CMS determines demonstration spending limits, he said.


  • 23 Aug 2018 7:48 AM | Matt Zavadsky (Administrator)


    This is potentially a driver of the “EMS Transformation” to being more than just a means of conveyance to a hospital, as EMS agencies become more of a default healthcare safety net provider in communities facing that may be facing fewer healthcare resources.

    -------------------------  

    Hospitals shut at 30-a-year pace in U.S., with no end in sight

    The next year to 18 months should see an increase in shut downs, with the risks coming following years of mergers and acquisitions.

    http://www.chicagobusiness.com/health-care/hospitals-shut-30-year-pace-us-no-end-sight

    (Bloomberg)—Industry M&A may be no savior as the pace of hospital closures, particularly in hard-to-reach rural areas, seems poised to accelerate.

    Hospitals have been closing at a rate of about 30 a year, according to the American Hospital Association, and patients living far from major cities may be left with even fewer hospital choices as insurers push them toward online providers like Teladoc Inc. and clinics such as CVS Health Corp’s MinuteClinic.

    Morgan Stanley analysts led by Vikram Malhotra looked at data from roughly 6,000 U.S. private and public hospitals and concluded eight percent are at risk of closing; another 10 percent are considered “weak." The firm defined weak hospitals based on criteria for margins for earnings before interest and other items, occupancy and revenue. The “at risk” group was defined by capital expenditures and efficiency. among others.

    The next year to 18 months should see an increase in shut downs, Malhotra said in a phone interview.

    The risks are coming following years of mergers and acquisitions. The most recent deal saw Apollo Global Management LLC swallowing rural hospital chain LifePoint Health Inc. for $5.6 billion last month. Apollo declined to comment on the deal; LifePoint has until Aug. 22 to solicit other offers. Consolidation among other health-care players, such as CVS’s planned takeover of insurer Aetna Inc., could also pressure hospitals as payers push patients toward outpatient services.

    There are already a lot of hospitals with high negative margins, consultancy Veda Partners health care policy analyst Spencer Perlman said, and that’s going to become unsustainable. Rural hospitals with a smaller footprint may have less room to negotiate rates with managed care companies and are often hobbled by more older and poorer patients.

    Also wearing away at margins are technological improvements that allow patients to get more surgeries and imaging done outside of the hospital.

    They “are getting eaten alive from these market trends,” Perlman cautioned.

    Future M&A options could be too late—buyers may hesitate as debt laden facilities like Community Health Systems Inc. and Tenet Healthcare Corp. focus on selling underperforming sites to reduce leverage, Morgan Stanley’s Zachary Sopcak said.

    The light at the end of the tunnel is some hospitals are rising to the occasion, Perlman said. Some acute care facilities are restructuring as outpatient emergency clinics with free-standing emergency departments. “Microhospitals,” or facilities with ten beds or less, are another trend that may hold promise.


  • 21 Aug 2018 8:54 AM | AIMHI Admin (Administrator)

    The Acute Community Care Program uses paramedics to provide in-home urgent care after regular business hours, aiming to prevent unnecessary emergency department visits.

    Lisa I. Iezzoni, MD, MSc; Amy J. Wint, MSc; W. Scott Cluett III, NRP; Toyin Ajayi, MD, MPhil; Matthew Goudreau, BS, NRP; Bonnie B. Blanchfield, CPA, SM, ScD; Joseph Palmisano, MA, MPH; and Yorghos Tripodis, PhD

    Am J Manag Care. 2018;24(9)

    https://www.ajmc.com/journals/issue/2018/2018-vol24-n9/early-experiences-with-the-acute-community-care-program-in-eastern-massachusetts

    PDF of the full report available here.

    ABSTRACT

    Objectives: Emergency departments (EDs) frequently provide care for non-emergent health conditions outside of usual physician office hours. A nonprofit, fully integrated health insurer/care delivery system that enrolls socioeconomically disadvantaged adults with complex health needs partnered with an ambulance service provider to offer after-hours urgent care by specially trained and equipped paramedics in patients’ residences. The Massachusetts Department of Public Health gave this initiative, the Acute Community Care Program (ACCP), a Special Project Waiver. We report results from its first 2 years of operation.

    Conclusions: This study using observational data provides preliminary evidence suggesting that ACCP might offer an alternative to EDs for after-hours urgent care. More rigorous evaluation is required to assess ACCP’s effectiveness.

    Takeaway Points
    The Acute Community Care Program (ACCP) is a collaboration between a nonprofit, fully integrated health insurer/care delivery system that enrolls socioeconomically disadvantaged adults and an ambulance service provider to offer after-hours urgent care by specially trained and equipped paramedics in patients’ residences. Without ACCP, these patients would typically be sent to emergency departments (EDs).

    Early results suggest that: 

    • ACCP appears to reduce ED visits for these urgent care patients. 
    • No unexpected deaths occurred. 
    • At least 90% of patients are willing to receive ACCP care in the future. 
    • More research is needed to quantify the effects of ACCP on ED use and patients’ experiences.
  • 18 Aug 2018 9:58 AM | AIMHI Admin (Administrator)
    Check out this recent American Ambulance Association video featuring Matt Zavadsky of AIMHI member Medstar Mobile Healthcare as well as Rob Lawrence of Paramedics Plus Alameda. Learn how your ambulance service can share patient stories to help tell the true, wholly human story of mobile healthcare.


  • 11 Aug 2018 8:25 AM | Amanda Riordan (Administrator)

    MedStar Mobile Healthcare CEO Douglas Hooten recently accepted the "2018 Our Driving Concern Texas Employer Traffic Safety Award" from the National Safety Council. See the photo on Facebook!

  • 5 Aug 2018 11:47 AM | Amanda Riordan (Administrator)

    Huge congratulations to AIMHI member Metropolitan Emergency Medical Services (MEMS) Pulaski County on their selection as the Arkansas Ambulance Association's ALS Service of the Year! 

    View the post on Facebook►

  • 29 Jul 2018 8:00 AM | AIMHI Admin (Administrator)

    By Mihir Zaveri

    July 29, 2018

    https://www.nytimes.com/2018/07/29/us/black-woman-ambulance-cost-florida.html

    Nicole Black got a call around 1:45 a.m. on July 4 that her daughter Crystle Galloway had fallen in the bathroom of her Tampa, Fla., condominium and that something was wrong. 

    She had hit her head, Ms. Galloway’s daughter said, and by the time Ms. Black raced from her home two blocks away, she was slumped over the bathtub, foaming at the mouth and her lips were swollen.

    Ms. Black called 911. Later that day, Ms. Galloway slipped into a coma. She died five days after.

    But weeks later, questions persist about what happened after the 911 call and whether race played a role in how Ms. Black and her daughter were treated. Four emergency medical workers have been placed on paid leave and face a disciplinary hearing on Tuesday.

    Ms. Black said that the responders told her she could not afford the $600 ambulance ride to take her daughter to the hospital, and that she was directed by the medics to drive her there on her own. Ms. Black said she believed her family was treated poorly because they are black.

    Officials in Hillsborough County, which provided the emergency medical response, disputed her account, denied that race played a role and said Ms. Black herself said she wanted to take her daughter to the hospital.

    But officials acknowledged other troubling issues: Nobody took Ms. Galloway’s vitals at the scene; responders failed to get a signed confirmation from Ms. Black that her daughter wouldn’t use the ambulance; and, in a follow-up report, medical workers indicated that they had not arrived at the scene at all that morning.

    Mike Merrill, the county administrator, put all four medical workers on paid leave.

    Ms. Black on Saturday would not disclose specific medical information about her daughter, but she said she did not believe she would have died if the responders had acted differently.

    “I’m devastated,” Ms. Black said. “I feel like my chest has been ripped open.”

    At a news conference last week, Mr. Merrill said he deeply regretted “that this has happened, and clearly this is unacceptable.”

    “My deepest sympathies to the family, and my deepest apologies for my fire medics not properly performing and caring for this patient,” he said.

    On June 27, Ms. Galloway had a cesarean section, giving birth to a boy. Recent news reports have highlighted the high rates of maternal mortalityamong black women. Nationally, they are three to four times as likely to die in pregnancy or childbirth as white women, according to the Centers for Disease Control and Prevention.

    Mr. Merrill said on Saturday that he had not received any information that would indicate that race was a factor influencing the medical workers’ actions, or that if they had acted differently, Ms. Galloway would have survived.

    The county identified the emergency medical workers as John Morris, 36, a lieutenant; Justin Sweeney, 36, and Andrew Martin, 28, both fire medics; and Cortney Barton, 38, an acting lieutenant. They could not be reached for comment.

    In statements released by the county, the responders described helping Ms. Galloway down the stairs of her home and placing her into Ms. Black’s car, but they denied refusing to take her.

    “By the time we realized that no information was obtained, the mother had already left the scene,” Lieutenant Morris wrote.

    He said that Ms. Black was “adamant” she would take her daughter to the emergency room and that “at no point would I advise against a person being transported by our rescue.”

    Derrik Ryan, president of Hillsborough County Firefighters Local 2294, said Ms. Black’s description of what happened was “not factual.” He said that the medical workers did not “talk her out of going to the hospital” and that they did not talk about the cost of the ambulance trip.

    Mr. Ryan called the assertion that race played a role in their interactions “totally ridiculous.”

    He acknowledged that the medical workers failed to get Ms. Galloway’s vitals and should have gotten Ms. Black to sign a document stating that they would not be taking Ms. Galloway to the hospital. He said that a medical worker mistakenly entered into a report that they didn’t reach Ms. Galloway.

    “Did we make minor mistakes on that call? Absolutely,” Mr. Ryan said. “We did not kill that lady and we did not refuse to transport that lady.”

    Mr. Merrill said two Hillsborough County sheriff’s deputies who also responded that night had some discussion with Ms. Black about the cost of transporting her daughter to the hospital.

    In a statement, a sheriff’s office spokesman said Ms. Black had asked one of the deputies if emergency medical workers would take Ms. Galloway to the hospital and if she would have to pay for the transport. According to the statement, the deputy responded affirmatively to both questions but did not further discuss the ambulance or its cost with Ms. Black.

    After Ms. Black filed a complaint, the sheriff’s office conducted a review and “determined no violations of agency policy or standards occurred,” the statement read.

  • 25 Jul 2018 11:39 PM | Amanda Riordan (Administrator)

    AIMHI leaders gathered at the Pinnacle EMS Conference in Phoenix this week to share experiences and best practices from their high performance systems. 




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