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Advantages and Disadvantages of Hospital-Based Emergency Medical Services in Rural Areas

Research center: NORC Walsh Center for Rural Health Analysis
Phone: 301.634.9300
Lead researcher: Curt D. Mueller, PhD
Contact: Michael Meit, MA, MPH, 301.634.9324, meit-michael@norc.org
Project funded: September 2003
Project completed: October 2008
Topics: Emergency medical services (EMS)
Hospitals and clinics
Many rural areas are served by low-volume Emergency Medical Services (EMS) providers. By definition, these providers are high-cost providers because the costs of capacity cannot be spread over a larger number of EMS transports. Revenue sources of low-volume providers are varied, and the Medicare Ambulance Fee Schedule may be changing revenue for many providers. Under this environment, there may be strong incentives for the rural hospital to acquire an ambulance or local EMS provider. The purpose of this project was to clarify issues surrounding the hospital's decision to acquire and maintain ownership of community ambulance services. Advantages and disadvantages of ownership are identified and analyzed, both conceptually, and informed by key informant interviews with CAH staff.

Publications

  • Experiences of Critical Access Hospitals in the Provision of Emergency Medical Services (Policy Brief)
    Date: 10/2008
    This brief presents NORC Walsh Center for Rural Health Analysis research conducted to better understand the experiences of CAHs in operating an EMS unit. Using key informant interviews, researchers examined motivations for acquiring EMS services and the effect of these services on the level of emergency care available in the community. The benefits and challenges that CAH providers face in operating EMS services are discussed.