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

Research center:
Lead researcher:
Project funded:
September 2003
Project completed:
October 2008
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.