News & Updates

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  • 4 Oct 2021 2:11 PM | AIMHI Admin (Administrator)

    Modern Healthcare source article


    October 04, 2021

    Air ambulance utilization and charges have been steadily increasing over the past several years, according to a new study.

    The average in-network negotiated rate for emergency transport by airplane—excluding mileage charges—rose 76.4%, from $8,855 in 2017 to $15,624 in 2020, according to a FAIR Health analysis of around 35 billion healthcare claims. But most air ambulance rides are out of network, leaving consumers to pay for most of the charges.

    The average charge associated with airplane ambulances rose 27.6%, from $19,210 in 2017 to $24,507 in 2020. The average Medicare reimbursement rose 4.7% to $3,216 over that span, the same rate increase as emergency helicopter rides.

    The average charge associated with ambulance by helicopter rose 22.2%, from $24,924 in 2017 to $30,446 in 2020.


    The Biden administration published an interim surprise billing rule last week, which states that providers and payers can turn to an independent dispute resolution process if an out-of-network provider and payer can't come to an agreement over payment during a 30-day "open negotiation."

    Read full article►

  • 4 Oct 2021 2:08 PM | AIMHI Admin (Administrator)

    Modern Healthcare Source Article


    October 01, 2021

    Providers are crying foul about a regulation from the Biden administration that lays out the process they can use to settle out-of-network billing disputes with payers.

    The rule, released Thursday by the Centers for Medicare and Medicaid Services, is the next step in its implementation of the surprise billing ban passed last year by Congress.

    Payers praised the regulation as the "right approach," while providers swiftly denounced it as a "miscue" arbitrarily favoring insurers. At issue is the part of the regulation that lays out the independent dispute resolution process used when there is a disagreement between providers and payers over the fair price for an out-of-network service.

    In the IDR process, both the insurer and provider tell an arbiter what they think the appropriate rate for an out-of-network service is. CMS directs the arbiter to presume the "qualifying payment amount," which is usually an insurer's median contracted rate for the same service in a geographic area, is the "appropriate" rate and pick the offer closest to that.

    In the providers' minds, that gives insurers too much leverage.

    "It goes way beyond protecting patients. It protects insurance companies and gives primary credence to their point of view and data," said Chip Kahn, CEO of Federation of American Hospitals. FHA is a trade group that represents for-profit hospitals.

     Continue reading►

  • 30 Sep 2021 10:36 PM | Matt Zavadsky (Administrator)

    This a VERY WELL-DONE, research and evidence-based commentary on the cause, effect, and recommended SOLUTIONS to ED overcrowding.

    It’s a bit long, but well worth the read!  A PDF of the commentary is attached.

    All facets of the healthcare system, including EMS, need to work together to appropriately navigate patients, especially those who access healthcare through ‘911’, through effective integration.

    Tip of the hat to Rob Lawrence for sharing this article!


    Emergency Department Crowding: The Canary in the Health Care System

    The solution for this serious threat to ED staff and harm to patients cannot come from a single department, but through engagement of and ongoing commitment by leaders throughout the hospital and, more broadly, by those in the payer and regulatory segments of the health care system as well.

    September 28, 2021

    By: Gabor D. Kelen, MD, Richard Wolfe, MD, Gail D’Onofrio, MD, MS, Angela M. Mills, MD, Deborah Diercks, MD, Susan A. Stern, MD, Michael C. Wadman, MD & Peter E. Sokolove, MD

    The impact of ED crowding on morbidity, mortality, medical error, staff burnout, and excessive cost is well documented but remains largely underappreciated.

    Among the most notable content in the commentary:

    Emergency department crowding is a sentinel indicator of health system functioning. While often dismissed as mere inconvenience for patients, impact of ED crowding on avoidable patient morbidity and mortality is well documented but remains largely underappreciated. The physical and moral harm experienced by ED staff is also substantial. Often seen as a local ED problem, the cause of ED crowding is misaligned health care economics that pressures hospitals to maintain inefficient high inpatient census levels, often preferencing high-margin patients. The resultant back-up of admissions in the ED concentrates patient safety risks there. Few efforts (even well-meaning ones) address the economically driven root causes of ED crowding, i.e., the need to achieve minimal financial hospital margins. The key to a sustainable solution is to realign health care financing to allow hospitals to keep inpatient capacity below a critical threshold of 90%; beyond that, hospital throughput dynamics will inevitably lead to ED crowding.

    Even prior to the Covid-19 pandemic, greater than 90% of U.S. EDs found themselves stressed beyond the breaking point at least some of the time. Many remain overwhelmed daily.

    The authors provide detailed commentary on:

    • Causes of Crowding and Why ED Crowding Persists
      • Health System Incentive Structure
      • Insufficient Health Care Capacity
      • Failure of Regulatory Agencies, Payers, and Legislative Bodies
      • Misunderstanding of the Issue
    • Solutions:
      • ED Input Solutions
        • Distinct from individual hospitals placing themselves on ambulance diversion is a new voluntary 5-year payment model by the Centers for Medicare & Medicaid Services (CMS): Emergency Triage, Treat, and Transport ET3 for Medicare fee-for-service beneficiaries calling 911. In this model, CMS will pay participants to transport to an alternative destination partner, including primary care offices, UCCs, or even community mental health centers. In and of itself, ideally, only low-acuity patients would be transported to other settings and, thus, no significant impact on ED crowding from boarding is expected. Indeed, we have apprehension about Medicare patients being sent by ambulance to nonemergency care settings given the occult medical vulnerabilities of such patients and the high rates of needed hospital admission associated with ambulance transports.
    • ED Throughput Solutions
      • Hospital Solutions to Relieve Access Block (Output)

    The authors recommend five essential elements to take on overcrowding in the ED:

    1. ED crowding must be acknowledged as the serious problem to patient safety that it is — and not the “inconvenience” it is perceived to be.
    2. Most important, there are no known examples of successful amelioration of ED crowding in any institution without significant visible buy-in and action directed from senior-most institutional leadership. This commitment must be continuously evident with incentives of management at all levels throughout the institution and aligned to resolve this most important patient safety concern.
    3. Many institutions operate on razor-thin margins. Health care financing must realign reimbursement from current practices that outright promotes ED boarding.
    4. Regulators such as TJC and CMS must clearly address the impact of crowding on patient safety, its potentiation of violence, and its implications for staff well-being; likewise, the Accreditation Council for Graduate Medical Education should consider the impact of crowding on training and trainee well-being within their credentialling criteria of institutions. The regulations should include clear metrics and associated penalties/consequences.
    5. Crowding is predictive and, accordingly, enforceable preemptive surge plans must be generated and actuated. When crowding does occur, it must be considered in the same light as a disaster with the same deliberate moral response.

  • 30 Sep 2021 10:33 PM | Matt Zavadsky (Administrator)

    Rural areas suffer from ambulance shortage

    CBS News Saturday Morning

    September 25, 2021

    Another compelling news story about the rural ambulance service challenges.

    While this CBS Saturday Morning news story, which aired September 25th, highlights the report from the Rural Health Policy Institute, similar challenges exist for many ambulance providers in urban and suburban communities as well.

    • Crisis level staffing shortages
    • Inadequate reimbursement
    • Lack of designation as an ‘Essential Service’

    In the news story, Alan Morgan, the director of the National Rural Health Association, states that the failing rural ambulance system may be contributing to the falling life expectancy in rural communities.  

    Here’s a link to the RHPI Report.

  • 25 Sep 2021 11:14 AM | AIMHI Admin (Administrator)

    CBS Saturday Morning Source | Comments by Matt Zavadsky

    The latest census report finds that 60 million Americans live in rural areas. The Centers for Disease Control and Prevention reports that they tend to be older, sicker and poorer than the average American. According to a study by the Rural Policy Institute, there are not enough ambulances to help in an emergency. CBS News transportation correspondent Errol Barnett has the story. Air Date: Sep 25, 2021

  • 7 Sep 2021 12:28 PM | AIMHI Admin (Administrator)

    CBS News Source Article | Comments by Matt Zavadsky

    Our healthcare system is buckling! 

    Scenarios like this should NOT be happening.  Please watch the video in the news link.  The frustration expressed by a caring physician who is simply trying to get the right care for his critical, non-COVID patient is compelling.  This scenario is playing out all over the country. 

    Non-COVID patients are dying because the hospitals are packed with COVID patients.  98.3% of people hospitalized with a COVID-19 diagnosis between May and July 2021 were unvaccinated (

    EMS response volumes and ER delays are also impacting local EMS systems – delaying care to critical 911 callers due to stretched EMS resources.

    Our healthcare system is buckling!! 


    Patients forced to wait thousands of minutes in rural Texas ER: "We've never seen this. Ever."


    SEPTEMBER 7, 2021

  • 2 Sep 2021 3:59 PM | AIMHI Admin (Administrator)

    WRDW Source | Comments by Matt Zavadsky

    The latest news report about an issue facing many EMS systems and communities across the country.

    AIMHI is hosting an international webinar with EMS, hospital and EMTALA experts on Tuesday, September 7th beginning at 1p Central Time.

    Click here to learn more and register for the event.


    COVID surge overruns local hospitals, slowing ambulance responses

    By Kennedi Harris

    Aug. 30, 2021

    AUGUSTA, Ga. (WRDW/WAGT) - The number of COVID patients continue to grow at all of our local hospitals. We’re told inside some hospitals, hallways are lined with patients waiting in chairs.

    At Augusta University Health, doctors say hallways are lined with beds. Outside the doors you may see lines of ambulances waiting to get in.

    In the past, Gold Cross EMS, Richmond County’s primary ambulance service provider, has reported long wait times outside of hospitals. That’s holding ambulance units up and leaving fewer units available on the street. Now Gold Cross says the COVID surge is making those wait times even longer.

    On Monday, under the emergency awning at University, there were lines of ambulances. AU Health and Doctors Hospital had a very similar sight. It’s an issue that COVID is making worse but there’s a way you can help.

    Before you make the call be prepared because you might have to wait.

    “We’re seeing wait times, that in some cases may seem astronomical. But this is a direct reflection of where we are based on COVID,” said Michael Myers, Gold Cross EMS director of business development.

    An ambulance can’t just drop a patient off and go. They must complete a transfer of care to the hospital. But because ERs are full, EMS crews are sitting outside with patients waiting for an ER room to open up. Depending on the timing the wait can be anywhere from 30 minutes to as long as six hours.

    “We can have a crew that can get to a hospital but, but they may have to wait there. In some cases, hours with a patient, because there’s no room inside,” he said.

    In a real example from over the weekend, Gold Cross picked up a patient at 9:58 a.m. and arrived at a local hospital at 10:34 a.m. but couldn’t leave until a room was available at 6:43 p.m.

    “We’ve always had wait times. COVID has extended the wait times” he said.

    Myers encourages you to think before you call so you’re not taking ambulances away from possibly more critical needs.

    “Because we are in these times of COVID, we have to make sure that we are using our resources in the most appropriate or efficient way as possible,” he said. “My thought processes - if you can drive yourself to an emergency room, you probably don’t need to call 911.”

    Myers says they’ve even seen people calling an ambulance to get tested for COVID. Don’t do that he says, get tested outside of the hospital if possible. If you do need to be taken to the ER by ambulance have patience. You won’t be seen any quicker just because you come by ambulance. Hospitals are caring for the most critical needs first.

  • 9 Aug 2021 5:15 PM | AIMHI Admin (Administrator)

    Congratulations to the 2021 AIMHI Award Winners!  

    2021 AIMHI Excellence in EMS Integration Awards

    • Texas Health Resources
    • Exodus Recovery
    • Washoe County, Nevada


    2021 AIMHI Leadership in Integrated Healthcare Awards

    •  Janice Knebl, DO, MBA, FACP, MACOI


    2021 AIMHI Excellence in Education

    • Pro EMS Refresh


    2021 AIMHI Excellence in Value Demonstration or Research Awards

    • Niagara EMS
    • University of Southern California & Los Angeles Fire Department


    2021 AIMHI Excellence in EMS Advocacy Awards (NEW CATEGORY!)

    • Senator Catherine Cortez Masto
    • Indiana State Senator Karen Tallian 


    2021 AIMHI Lifetime Achievement Awards

    • Josef Penner
    • Jon Swanson

  • 23 Jul 2021 9:20 AM | AIMHI Admin (Administrator)

    Modern Healthcare Source | Comments Courtesy of Matt Zavadsky

    This is topic at many EMS agencies across the country.  Following the lead of other healthcare entities may provide some guidance.


    American Hospital Association supports COVID-19 vaccine mandates


    July 21, 2021


    The American Hospital Association supports hospitals and health systems that require their workers to get the COVID-19 vaccine, the group announced Wednesday.


    AHA, which represents nearly 5,000 hospitals and health systems, joins dozens of providers and several associations that have also backed vaccine mandates for healthcare workers.


    "The evidence is clear: COVID-19 vaccines are safe and effective in reducing both the risk of becoming infected and spreading the virus to others," AHA CEO Rick Pollack said in prepared remarks. "The AHA supports hospitals and health systems that choose, based on local factors, to mandate COVID-19 vaccines for their workforce. Doing so will help protect the health and well-being of healthcare personnel and the patients and communities they proudly serve."


    Low vaccination rates in nearly half of the country may prompt another wide-scale surge, healthcare providers warn, noting that some hospitals are already overrun. Arkansas, Louisiana and Missouri have been some of the hardest hit by COVID-19 variants, where only 35% to 41% of their residents are fully vaccinated, according to data from Johns Hopkins University School of Medicine's Coronavirus Tracking Center. The unvaccinated account for 97% of people hospitalized for severe COVID-19, said Rochelle Walensky, director of the Centers for Disease Control and Prevention.


    COVID-19 cases have increased in more than three dozen states, according to the seven-day trailing average from Johns Hopkins University School of Medicine's Coronavirus Tracking Center. The rate of new cases has more than doubled over a two-week span, the CDC reports.


    More hospitals and health systems are forcing their workers to get inoculated and hospital and medical professional associations are following suit. America's Essential Hospitals, which represents more than 300 hospitals and health systems, also supported vaccine decrees Wednesday, joining the Association of American Medical Colleges and the Association for Professionals in Infection Control and Epidemiology.


    "By requiring vaccination for all employees, essential hospitals can set the example we need to improve those numbers, turn back the pandemic's latest assault and build equity for all people," Dr. Bruce Siegel, CEO of America's Essential Hospitals, said in prepared remarks, adding that vaccines are safe and effective at preventing COVID-19 and reducing its spread. "We have lost too many of our caregivers to COVID-19. Vaccination can reduce the risk we lose more."

  • 13 Jul 2021 10:31 PM | AIMHI Admin (Administrator)

    HHS Source Article | Comments Courtesy of Matt Zavadsky

    Perhaps a good opportunity for local EMS agencies to communicate with their state EMS and Medicaid Offices to be included in potential applications?


    CMS Addresses Substance Use, Mental Health Crisis Care for Those with Medicaid

    $15 Million Funding Opportunity for State Planning Grants to Bolster Mobile Crisis Intervention Services

    The Centers for Medicare & Medicaid Services (CMS) announced a funding opportunity made possible by the American Rescue Plan (ARP) to help states strengthen system capacity to provide community-based mobile crisis intervention services for those with Medicaid. The $15 million funding opportunity is available to state Medicaid agencies for planning grants to support developing these programs.

    This funding opportunity provides financial resources for state Medicaid agencies to assess community needs and develop programs to bring crisis intervention services directly to individuals experiencing a mental health or substance use related crisis outside a hospital or facility setting. These services may include screening and assessment, stabilization and de-escalation, and coordination of referrals after the initial treatment.

    "Investing in crisis intervention services ensures Americans experiencing a mental health or substance use disorder crisis get the care and treatment they need," said Secretary Becerra. "These grants will help states build these critical services to help communities send a responder who is trained and ready to assist people in crisis."

    "It is vital that we can meet people where they are, especially when those individuals are in crisis," said CMS Administrator Chiquita Brooks-LaSure. "This funding will help state Medicaid agencies plan innovative ways to provide and better mobilize these essential intervention services to their communities."

    The planning grants provide funding to develop, prepare for, and implement qualifying community-based mobile crisis intervention services under the Medicaid program. Grant funds can be used to support states' assessments of their current services, strengthen capacity and information systems, ensure that services can be accessed 24 hours a day/365 days a year, provide behavioral health care training for multi-disciplinary teams, or to seek technical assistance to develop State Plan Amendment (SPAs), demonstration applications, and waiver program requests under the Medicaid program.

    Letters of Intent to apply from states and territories are due July 23, 2021. Final applications must be submitted by August 13, 2021, 3:00 pm ET. The period of performance for this grant will be from September 30, 2021, through September 29, 2022. The Notice of Funding Opportunity (NOFO) provides additional details regarding eligibility and program requirements, as well as key deadline and application submission information.

    To view the NOFO, visit and search for the announcement by CFDA# 93.639.

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