Take a look at our newsletter this month!
HELPING EMS & HEALTHCARE LEADERS REVIEW, REFOCUS, AND RESET THEIR ORGANIZATIONS FOR SUCCESS. IN PERSPECTIVE
Volume 1 • JULY 2019
EMS ECONOMICS: KNOW YOUR NUMBERS …ANDWHAT TO DOWITH THEM. A Right and a Wrong Way to Ask for Increased Subsidization
T he economics of business in our EMS world are changing. It’s an unfortunate reality but one every agency will have to address at one point or another. In order to keep operations running, you’ll likely have to ask municipal officials in the community for increased subsidization. It’s important that you do your homework before you get to the meeting at Town Hall. If you pride yourself on not being a numbers person, I’m sorry to say you’ll have to re-think that. Creating a presentation for funding is definitely a numbers game. You’ll need to know the numbers related to your demographics and collection rates, and exactly how the money you’re requesting will be spent — and that’s just for starters. Here’s some additional material you’ll need to gather. RESPONSES VS. TRANSPORTS One important aspect to discuss during these meetings is the number of calls you’re responding to that don’t result in a transport. Nowadays, the vast majority of services are only paid based on their number of transports, but it’s important for city officials to see that even if you respond to 4,000 calls and only transport 3,200, you still had to incur expenses as “cost of readiness.” You had to have a crew ready to respond to all 4,000 requests for service.
HEART ATTACKS DON’T MAKE APPOINTMENTS When money is short, outsiders first recommend cutting back on hours during slower times. While we can reduce the number of ambulances available in the evening, we can’t shut down the service. The basis of EMS is we are available to help 24/7. Just like patients don’t plan for the most opportune time to suffer an injury or have a heart attack, we can’t plan for emergencies not to happen during a specific time of day or night to balance our budgets. In other businesses, you cut back and slow down when it’s slow. In EMS, we can only cut back to a certain point. PAYMENT UNCERTAINTY Municipal officials also need to understand that if you respond to 4,000 calls and transport 3,200 patients, the vast majority of those 3,200 patients aren’t paying full “IT’S IMPORTANT FOR CITY OFFICIALS TO SEE THAT EVEN IF YOU HAD TO RESPOND TO 4,000 CALLS AND ONLY TRANSPORT 3,200, YOU STILL HAD TO INCUR EXPENSES AS ‘COST OF READINESS.’”
price. That’s where understanding payer mix is important. If you can determine the percentage of those 3,200 patients who are on Medicare and Medicaid and then show them that data graphically, then you can pinpoint exactly how much money is lost. EMS is the only niche in medical industry that does not know how it will be paid for any of its services until after it provides said service, and, while it’s not the patients’ fault, the impact on agencies’ abilities to treat is real, and community leaders need to know. All this information needs to be put into graphics that you can send with a budget request. Most services think they can just walk in a meeting and request $100,000 without answering questions, but this strategy won’t get you far. If you need help crafting your own budget presentation, let me help. Shoot me an email at Bob@Holdsworth.com! This month, in Access Point Members Only, we’ll dive even deeper into EMS
economics. Want more info? Go to Holdsworth. com/AccessPoint.
1
• HOLDSWORTH.COM •
IS THE EMERGENCY TRIAGE, TREAT, AND TRANSPORT MODEL (ET3) INITIATIVE REALLY THE WAVE OF THE FUTURE?
Since this new trial program was announced by Center for Medicare and Medicaid Services (CMS) on May 22, 2019, the industry has been touting it as the greatest thing ever … but is it? More importantly, can your service participate in this five-year trial program? The Request for Applications (RFA) was announced in May, and applications are expected to be accepted this summer with the initial participants chosen this fall. January of 2020 through December of 2024 will be the performance period. One challenge is the program was released with a very short time frame for applicants to submit eligibility. Most states do not have guidelines to allow for compliance with the program, few have telemedicine established, and all participant groups must have transported at least 15,000 Medicare patients in 2017, so only a few will have the ability to start. The premise behind the program is solid: Let’s try to triage and treat more patients in their homes, transport only when absolutely necessary, and then make sure they get to the best (most cost effective) destination possible.
The five-year test period is only supposed to look at two specific parameters: 1. Payment for transportation to alternative destinations not currently covered by Medicare, and 2. Payment for treatment in place, rendered by an appropriate health care practitioner at the scene via telehealth The overall goals of the initiative are to test a new way to pay for ambulance service by Medicare and Medicaid: • Reduce costs to the program, extending its life • Reduce the burden on overworked 9-1-1 systems and responders • Relieve the pressure on overcrowded emergency departments • Encourage providers/communities to invest in medical triage capabilities On the surface, it looks like a win. To those of us who’ve been around for a while, it’s obvious the initiative may negatively impact small community-based agencies and favor large conglomerate providers. Most states and providers are not ready. While many states have authorized Mobile Integrated Healthcare regulatory guidance
or pilot programs, few have developed policies to allow for transportation to alternative destinations. Telehealth and telemedicine initiatives in EMS are in their infancy. We are all still arguing over the legalities and policies of having cameras in the patient compartments. Only huge private providers and countywide providers have established phone triage capabilities. These all cost money, and few are willing to invest unless they see a sure path to profitability. It will be critical for EMS leaders across the country to keep on top of the reports coming out from these test providers. Their demonstrated successes will eventually become our new reality, and your payment structure will morph from treat-and- transport, to triage, treat, and possibly transport. For more information about this program and to download the RFA document, see the webinar overview or get on the ET3 update mailing list at this link: Innovation.cms. gov/Initiatives/ET3/ and then follow the links on the page.
Online Resources, Real World Results HEALTHYRESPONDERS.COM: HELPING YOU STAY FIT FOR DUTY!
Hey, everyone! I have exciting news. I have over-the-top, shout- it-from-the-rooftops, wave-your-hands-in-the-air news. Healthy Responders will be going live this month! Tailored specifically to the first responder community to encourage longer and stronger lives, Healthy Responders offers three types of app-based programs you can choose from based on what your goals are, how much time you have to dedicate, and what your budget is. But the best part of all three programs is the app is based on a partnership with Virtual Health, so you can get real live feedback from a nutritionist 24/7. You can communicate with experts who can help build delicious recipes and find sustainable snacks you can take on the job. It also offers access to ample exercise programs depending on your personal
goals. You can even sign up to take exercise classes with a fitness instructor live, or you can participate in classes at your own pace. With a Healthy Responders membership, you’ll have access to nutritional guides, exercise plans, recipes, and your own personal tracker all in one convenient location: your pocket. Taking your own health into consideration while on shift can be extremely difficult. But it doesn’t have to be anymore. Constantly going from hours of boredom to springing to immediate action is hard on the body, so you need to make your own health a priority to stay on top of your game. With Healthy Responders, you can. Go to HealthyResponders.com to check out which program is right for you. If you have any questions, don’t hesitate to let me know!
2
• HOLDSWORTH.COM •
‘Ego Is the Enemy’ GET OVER YOURSELF AND FIND SUCCESS
Once in a while, a book comes along with a truly transcendent message.
“The Obstacle Is the Way,” tackles the difficulties of the creative process and our natural tendency to avoid necessary steps toward our success. “Ego Is the Enemy” dives deeper into the latter concept, highlighting ways we sabotage or deceive ourselves. For Holiday, ego is defined loosely as our perception of self. Some may have a poorer outlook on themselves than others, but, as the book’s title suggests, ego hurts us regardless of which end of the spectrum we fall on. Holiday argues our self-perception can act as a roadblock and a pitfall: Those with low self-esteem are stopped by doubt, while those with inflated egos often trip over their own arrogance. Those who unshackle themselves from their own personal narratives, however, can find lasting success.
“Ego Is the Enemy” is rich with examples of this concept in action as it explores the lives and contributions of often overlooked historical figures like Katharine Graham and Howard Hughes. These powerful individuals remain relatively obscure thanks to their tendency to put their work before self-promotion, yet their impact on global events is undeniable. Pulling from history, literature, and the latest psychological findings, Holiday weaves an argument as engaging as it is thought-provoking. At times contemplative and other times combative, “Ego Is the Enemy” holds up a mirror to readers and asks them to challenge what they see. For those willing to attempt conquering themselves, this book is a worthy companion.
“Ego Is the Enemy” by Ryan Holiday is one such work. This book is not just for business owners, athletes, or those trying to lose weight; it’s a guide for everyone . By digging into the root of the human condition, this instant bestseller examines the single greatest threat to our own success: ourselves. This ambitious premise shouldn’t come as a surprise if you’re familiar with the author. Dropping out of college at 19 to be mentored by business strategist Robert Greene, Holiday has become one of the most trusted advisors of our time, working with brands like Google, Taser, and Complex. His other bestseller,
ANYTIME QUICHE INGREDIENTS
• 5 large eggs • 2 cups milk or half-and-half • 1 tbsp melted butter or olive oil • Salt and pepper, to taste • 1/4 tsp garlic powder • 1 tbsp dried herbs (like Penzeys Spices “Sunny Paris”) • 1/4 cup scallions, diced • 1/2 cup diced ham or bacon, cooked crispy and crumbled
Where’s the Fun?
• 1 cup shredded cheddar cheese • 1 cup fresh spinach, chopped • 1 cup flour • 1 1/2 tsp baking powder • 1/4 tsp salt
DIRECTIONS
1. Heat oven to 400 F. 2. In a medium-sized bowl, combine eggs, milk, melted butter, salt, pepper, garlic powder, and herbs. Beat until frothy. 3. Grease a pie plate and add scallions, ham or bacon, cheese, and spinach. 4. In a small bowl, combine flour, baking powder, and 1/4 tsp salt. Add to egg mixture, stirring well. Pour mixture into pie plate. 5. Bake at 400 F for 30 minutes.
3
• HOLDSWORTH.COM •
269 Main Street Cromwell, CT 06416 HOLDSWORTH.COM
PRST STD US POSTAGE PAID BOISE, ID PERMIT 411
INSIDE THIS ISSUE
1 2 2 3 3 4
EMS Economics 101
Is ET3 the Wave of the Future?
HealthyResponders.com: Helping You Stay Fit for Duty!
Your Ego Is Holding You Back
Anytime Quiche
Fourth of July Fun Facts!
FOURTH OF JULY FUN FACTS!
Did You Know?
approximately 150 million hot dogs are consumed by Americans on the Fourth of July. That’s enough hot dogs to stretch all the way from Washington D.C. to Los Angeles five times! In addition to funding their hot dog eating antics, Americans will spend upwards of $7.1 billion on other cookout expenses to ring in their epic Independence Day celebrations! A DATE MIX-UP Do you remember John Trumball’s 1819 painting depicting all the Founding Fathers and Continental Congress huddled over the Declaration of Independence? While it’s nice to believe all the important men got together in one room to mull over the document and sign it together, that’s not what actually happened. July 4 may mark the day the document was formally dated,
finalized, and adopted, but it wasn’t actually signed until August 2.
RHODE ISLAND IS WHERE IT’S AT! Long before Independence Day was recognized as a national holiday — 85 years prior, in fact — the town of Bristol, Rhode Island started honoring the end of the Revolutionary War in their own way. Starting in 1785, Bristol began celebrating the colonies’ win over the British and were the only people officially celebrating for nearly nine decades! Billed as “America’s Oldest Fourth of July Celebration,” this town will be celebrating America’s 243rd birthday this year!
One of our nation’s most coveted of holidays, Independence Day, takes place this month, and while this is a day filled with energetic water games, delicious barbecue cuisine, and larger-than-life fireworks, for those of us in EMS, this day can mean utter chaos. To give you a break from the burns, eye injuries, and severed- hand-by-firework accidents (yes, this one happens all the time), I figured I’d offer up some interesting Fourth of July fun facts! HOT DOG HEAVEN According to the National Hot Dog and Sausage Council (yes, that’s a thing!),
Learn more about this historic town by visiting FourthOfJulyBristolri.com/.
Be safe out there this year! Happy Fourth of July!
4
• HOLDSWORTH.COM •
Page 1 Page 2 Page 3 Page 4Made with FlippingBook - professional solution for displaying marketing and sales documents online