DOCSLIB.ORG

Medicare's Ground Ambulance Data Collection System

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Medicare's Ground Ambulance Data Collection System Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services CMS Alliance to Modernize Healthcare (The Health FFRDC) A Federally Funded Research and Development Center Medicare Ambulance Services Special Analysis Task Order No. HHSM-500-T0052 Medicare’s Ground Ambulance Data Collection System: Sampling and Instrument Considerations and Recommendations Final July 30, 2019 The views, opinions, and/or findings contained in this report are those of The MITRE Corporation and should not be construed as official government position, policy, or decision unless so designated by other documentation. © 2019, The MITRE Corporation. All Rights Reserved. Medicare’s Ground Ambulance Data Collection System: Sampling and Instrument Considerations and Recommendations © 2019 The MITRE Corporation. ALL RIGHTS RESERVED. Approved for Public Release: 19-0989. Distribution Unlimited. Centers for Medicare & Medicaid Services Authors of this Report (the Health FFRDC Team) Andrew Mulcahy (RAND) Kirsten Becker (RAND) Jonathan Cantor (RAND) Scott Ashwood (RAND) Jeanne Ringel (RAND) Lisa Sontag-Padilla (RAND) Christine Buttorff (RAND) Michael Robbins (RAND) Susan Lovejoy (RAND) Thomas Goughnour (RAND) Sara Heins (RAND) Beverly Weidmer (RAND) Monique Martineau (RAND) Mike Oelrich (MITRE) Jennifer Gildner (RAND) Gina Karimi (RAND) Thomas Goode (RAND) Medicare’s Ground Ambulance Data Collection System: Sampling and Instrument Considerations and Recommendations ii © 2019 The MITRE Corporation. ALL RIGHTS RESERVED. Approved for Public Release: 19-0989. Distribution Unlimited. Centers for Medicare & Medicaid Services Acronyms Acronym Definition AAA America Ambulance Association ACS American Community Survey AFS Ambulance Fee Schedule ALS Advanced Life Support BBA Bipartisan Budget Act of 2018 BLS Basic Life Support CAH Critical Access Hospital CDC Centers for Disease Control and Prevention CES Cost Element Structure CMS Centers for Medicare & Medicaid Services EMR Emergency Medical Responder EMS Emergency Medical Services EMSCAP Emergency Medical Services Cost Analysis Project ESRD End-Stage Renal Disease FDA Food and Drug Administration FFRDC Federally Funded Research and Development Center FTE Full-Time Equivalent GAO Government Accountability Office GEMT Ground Emergency Medical Transportation HCPCS Healthcare Common Procedure Coding System HCRIS Healthcare Cost Report Information System HHS Department of Health and Human Services HIPAA Health Insurance Portability and Accountability Act HRSA Health Resources and Services Administration IAFC International Association of Fire Chiefs IAFF International Association of Fire Fighters IDR Integrated Data Repository IOM Institute of Medicine MedPAC Medicare Payment and Advisory Commission NAEMT National Association of Emergency Medical Technicians Medicare’s Ground Ambulance Data Collection System: Sampling and Instrument Considerations and Recommendations iii © 2019 The MITRE Corporation. ALL RIGHTS RESERVED. Approved for Public Release: 19-0989. Distribution Unlimited. Centers for Medicare & Medicaid Services Acronym Definition NASEMSO National Association of State EMS Officials NHSTA National Highway Transportation Safety Administration NPI National Provider Identifier NPPES National Plan and Provider Enumeration System NRHA National Rural Health Association NVFC National Volunteer Fire Council ONC Office of the National Coordinator for Health Information Technology PDF Portable Document Format PECOS Provider Enrollment, Chain and Ownership System RVU Relative Value Unit SNF Skilled Nursing Facility SUV Sport Utility Vehicle Medicare’s Ground Ambulance Data Collection System: Sampling and Instrument Considerations and Recommendations iv © 2019 The MITRE Corporation. ALL RIGHTS RESERVED. Approved for Public Release: 19-0989. Distribution Unlimited. Centers for Medicare & Medicaid Services Executive Summary Introduction The Bipartisan Budget Act of 2018 (BBA of 2018); Public Law 115-123, Section 50203(b) requires the Secretary of the Department of Health and Human Services (HHS) to develop a data collection system to collect data on costs, revenue, and utilization, and other information deemed appropriate by the Secretary, from a representative sample of entities that furnish ground (i.e., land and water) ambulance services. The BBA of 2018 specifies that the data collection system applies to Medicare ambulance “providers”—hospitals and other facilities that are Medicare “providers of service”—and Medicare ambulance “suppliers”—all other organizations that enroll in Medicare specifically to furnish and bill for ground ambulance services. The BBA of 2018 further requires the Medicare Payment Advisory Commission (MedPAC) to use the collected data to assess the relationship between Medicare’s payment rates and the cost of providing ground ambulance services. The Center for Medicare and Medicaid Services (CMS) commissioned support from the CMS Alliance for Modernizing Health Care Federally Funded Research and Development Center (the Health FFRDC) in developing the data collection instrument and sampling plan to meet these requirements. This report summarizes the Health FFRDC’s work under this effort, including: • An overview of the ground ambulance industry (Chapter 2) • A summary and comparison of existing tools to collect information related to ground ambulance costs, revenue, and volume (Chapter 3) • Findings from discussions with ground ambulance providers and suppliers (collectively, “ground ambulance organizations”1) and industry groups (Chapter 4) • Analysis of ground ambulance organization characteristics and Medicare ground ambulance service volume and mix using available Medicare data (Chapter 5) The final chapters of the report present the Health FFRDC’s recommendations to CMS regarding the development of a sampling plan (Chapter 6) and an instrument to collect data (Chapter 7) to meet the requirements specified in the BBA of 2018. We include a data collection instrument consistent with our design recommendations in an appendix to this report (Appendix E). The findings in Chapters 2 through 5 describe our work to arrive at our recommendations and offer support for specific recommendations. Readers primarily interested in the Health FFRDC’s recommendations are directed to Chapters 6 and 7 and the instrument in Appendix E. Ground Ambulance Services in Medicare Medicare covers medically necessary ground ambulance services meeting certain conditions.2 These services are provided by a diverse set of organizations enrolled in Medicare as providers or suppliers, including fire departments, hospitals, stand-alone government agencies, non-profit 1 Air ambulance organizations and services are out of scope for both CMS’s ground ambulance data collection system and for this report. 2 In addition to medical necessity, Medicare requires that (a) transports are to the nearest appropriate facility given the patient’s condition, and (b) all other forms of transportation are contraindicated. Medicare’s Ground Ambulance Data Collection System: Sampling and Instrument Considerations and Recommendations v © 2019 The MITRE Corporation. ALL RIGHTS RESERVED. Approved for Public Release: 19-0989. Distribution Unlimited. Centers for Medicare & Medicaid Services organizations, and private for-profit companies. While most Medicare transports are covered by the Medicare Part B medical benefit, transports involving inpatients at a hospital or other facility fall under the Part A hospital benefit. Medicare pays ambulance organizations3 for Part B-covered transports using the Ambulance Fee Schedule (AFS). The AFS establishes a base rate that varies by the level of transport provided (e.g., basic life support vs. advanced life support). The AFS also includes a per-mile rate applied to the distance traveled with the patient. The AFS incorporates a permanent add-on payment of a 50 percent increase in the standard mileage rate for ground ambulance transports that originate in rural areas where the travel distance is between 1 and 17 miles. Both base and mileage payments are only made when a patient is transported—in other words, Medicare does not pay for ambulance responses to calls for service that do not result in a patient transport. Since the inception of the AFS in 2002, the base and mileage payment rates have been modified by three temporary “add-on” payments that are higher for transports originating in rural areas. These add-ons have been extended several times, most recently by the BBA of 2018. Challenges in Comparing Payment Rates to Costs Assessing how Medicare payment rates are related to costs is complicated by the significant variation in ambulance organizations and by differences in how ambulance services are delivered and financed across communities. Ambulance organizations vary in the mix of services they provide, including the share of responses resulting in transport, the blend of emergency and non- emergency transports, and, even within emergency and non-emergency transport categories, the level of transport.4 Different types of services require different capabilities and inputs and therefore contribute differentially to organizations’ costs. Furthermore, many ambulance organizations share personnel, facilities, and vehicles with other services such as fire departments or hospitals. Determining the specific share of costs that should be allocated to their ambulance services for the purposes of comparing payments to costs is challenging. Furthermore, manyambulance organizations receive significant
Load more

Recommended publications
  • Data Collection WP Template
    Distr. GENERAL 02 September 2013 WP 14 ENGLISH ONLY UNITED NATIONS ECONOMIC COMMISSION FOR EUROPE CONFERENCE OF EUROPEAN STATISTICIANS Seminar on Statistical Data Collection (Geneva, Switzerland, 25-27 September 2013) Topic (ii): Managing data collection functions in a changing environment THE BUSINESS STATISTICAL PORTAL: A NEW WAY OF ORGANIZING AND MANAGING DATA COLLECTION PROCESSES FOR BUSINESS SURVEYS IN ISTAT Working Paper Prepared by Natale Renato Fazio, Manuela Murgia, Andrea Nunnari, ISTAT – Italian National Statistical Institute I. Introduction 1. A broad shift of the social and technological context requires ISTAT to modify the way data are collected in order to improve the efficiency in producing timely estimates and, at the same time, to increase or at least maintain the level of data quality, while reducing respondent burden. All of this, within a climate of general budgets cuts. 2. In 2010, as a way to deal with these challenges, a medium-long term project was launched (Stat2015), envisaging the gradual standardisation and industrialisation of the entire cycle of ISTAT statistical processes, according to a model based on a metadata-driven, service-oriented architecture. With regard to data collection, as well for the other production phases, Stat2015 aims at outlining strong enterprise architecture standards. 3. A first step along these lines was to develop a comprehensive set of requirements according to which select, design or further develop the IT tools supporting data collection. The requirements encompassed four areas, covering the main functions of the entire (data collection) process: i) Survey unit management, ii) Data collection management, iii) Questionnaire, iv) Communication facilities. 4. A significant contribution to the definition and implementation of these requirements came with the development of the new ISTAT Business Statistical Portal, a single entry point for Web-based data collection from enterprises, which is at the same time an attempt to streamline the organization and management of business surveys as a whole.
    [Show full text]
  • Standardization and Harmonization of Data and Data Collection Initiatives
    Conference of the Parties to the WHO Framework Convention on Tobacco Control Fourth session FCTC/COP/4/15 Punta del Este, Uruguay, 15–20 November 2010 15 August 2010 Provisional agenda item 6.2 Standardization and harmonization of data and data collection initiatives Report of the Convention Secretariat INTRODUCTION 1. At its third session (Durban, South Africa, 17–22 November 2008) the Conference of the Parties requested the Convention Secretariat to compile a report on data collection measures, in decision FCTC/COP3(17). The decision outlined the fact that this should be undertaken under the guidance of the Bureau, and with the assistance of competent authorities within WHO, in particular WHO’s Tobacco Free Initiative, as well as relevant intergovernmental and nongovernmental organizations with specific expertise in this area. Paragraph 6 of the decision stated that the report should cover measures: to improve the comparability of data over time; to standardize1 collected data within and between Parties; to develop indicators and definitions to be used by Parties’ national and international data collection initiatives; and to further harmonize2 with other data collection initiatives. 2. The request to provide such a report is in line with Article 23.5 of the Convention, which requires the Conference of the Parties to “keep under regular review the implementation of the Convention” and to “promote and guide the development and periodic refinement of comparable methodologies for research and the collection of data, in addition to those provided for in Article 20, relevant to the implementation of the Convention”. 1 Standardization: the adoption of generally accepted uniform technical specifications, criteria, methods, processes or practices to measure an item.
    [Show full text]
  • Ambulance Transportation Billing Guide
    Washington Apple Health (Medicaid) Ambulance Transportation Billing Guide January 1, 2021 Disclaimer Every effort has been made to ensure this guide’s accuracy. If an actual or apparent conflict between this document and a Health Care Authority (HCA) rule arises, HCA rules apply. Billing guides are updated on a regular basis. Due to the nature of content change on the internet, we do not fix broken links in past guides. If you find a broken link, please check the most recent version of the guide. If this is the most recent guide, please notify us at [email protected]. About this guide* This publication takes effect January 1, 2021, and supersedes earlier billing guides to this program. HCA is committed to providing equal access to our services. If you need an accommodation or require documents in another format, please call 1-800-562- 3022. People who have hearing or speech disabilities, please call 711 for relay services. Washington Apple Health means the public health insurance programs for eligible Washington residents. Washington Apple Health is the name used in Washington State for Medicaid, the children’s health insurance program (CHIP), and state-only funded health care programs. Washington Apple Health is administered by the Washington State Health Care Authority. Refer also to HCA’s ProviderOne Billing and Resource Guide for valuable information to help you conduct business with HCA. How can I get HCA Apple Health provider documents? To access provider alerts, go to HCA’s provider alerts webpage. To access provider documents, go to HCA’s provider billing guides and fee schedules webpage.
    [Show full text]
  • Data Collection and Analysis Plan FAMILY OPTIONS STUDY
    Data Collection and Analysis Plan FAMILY OPTIONS STUDY UU.S..S. DDepaepartmentrtment ofof HouHousingsing andand UrUrbanban DevDevelopelopmmentent || OOfficeffice ofof PolicPolicyy DevDevelopelopmentment andand ResReseaearchrch Visit PD&R’s website www.huduser.org to find this report and others sponsored by HUD’s Office of Policy Development and Research (PD&R). Other services of HUD USER, PD&R’s research information service, include listservs, special interest reports, bimonthly publications (best practices, significant studies from other sources), access to public use databases, and a hotline (800-245-2691) for help accessing the information you need. Data Collection and Analysis Plan FAMILY OPTIONS STUDY Prepared for: U.S. Department of Housing and Urban Development Washington, D.C. Prepared by: Abt Associates Inc. Daniel Gubits Michelle Wood Debi McInnis Scott Brown Brooke Spellman Stephen Bell In partnership with : Vanderbilt University Marybeth Shinn March 2013 Disclaimer Disclaimer The contents of this report are the views of the authors and do not necessarily reflect the views or policies of the U.S. Department of Housing and Urban Development or the U.S. Government. Family Options Study Data Collection and Analysis Plan Table of Contents Family Options Study Revised Data Collection and Analysis Plan Table of Contents Chapter 1. Introduction and Evaluation Design .................................................................................. 1 1.1 Overview and Objectives ........................................................................................................
    [Show full text]
  • Ground Data Collection and Use
    ANDREWS. BENSON WILLIAMC. DRAEGER LAWRENCER. PETTINGER University of California* Berkeley, Calif. 94720 Ground Data Collection and Use These are essential components of an agricultural resource survey. INTRODUCTION sions based on their efforts to perform re- HE IMPORTANCE OF collecting meaningful gional agricultural inventories in Maricopa T and timely ground data for resource in- County, Arizona, using space and high-alti- ventories which employ remote sensing tech- tude aerial photography, as part of an ongoing niques is often discussed, and appropriately NASA-sponsored research project (Draeger, so. However, those wishing to conduct inven- et a]., 1970). This paper draws upon examples tories frequently fail to devote as much time from this research. However, much of the dis- to the planning of field activities which occur cussion is relevant to other disciplines for in conjunction with an aircraft mission as which ground data is important. they do in planning the flight itself. As a re- sult. adequate remote sensing data mav be collected,-but no adequate sipporting infor- Preliminary evaluation of the geographical ABSTRACT:During the past two years, extensive studies have been conducted out in the Phoenix, Arizona area to ascertain the degree to which sequential high- altitude aircraft and spacecraft imagery can contribute to operational agri- cultural crop surveys. Data collected on the ground within the test site con- stituted an essential component of the three phases of the survey: (I)farniliariza- tion with the area and design of preliminary evalz~ationexperiments, (2) train- in,g of interpreters, and (3)providing the basis upon which image interpretation estimates can be adjusted and evaluated.
    [Show full text]
  • Design and Implementation of N-Of-1 Trials: a User's Guide
    Design and Implementation of N-of-1 Trials: A User’s Guide N of 1 The Agency for Healthcare Research and Quality’s (AHRQ) Effective Health Care Program conducts and supports research focused on the outcomes, effectiveness, comparative clinical effectiveness, and appropriateness of pharmaceuticals, devices, and health care services. More information on the Effective Health Care Program and electronic copies of this report can be found at www.effectivehealthcare.ahrq. gov. This report was produced under contract to AHRQ by the Brigham and Women’s Hospital DEcIDE (Developing Evidence to Inform Decisions about Effectiveness) Methods Center under Contract No. 290-2005-0016-I. The AHRQ Task Order Officer for this project was Parivash Nourjah, Ph.D. The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views ofAHRQ or the U.S. Department of Health and Human Services. Therefore, no statement in this report should be construed as an official position of AHRQ or the U.S. Department of Health and Human Services. Persons using assistive technology may not be able to fully access information in this report. For assistance contact [email protected]. The following investigators acknowledge financial support: Dr. Naihua Duan was supported in part by NIH grants 1 R01 NR013938 and 7 P30 MH090322, Dr. Heather Kaplan is part of the investigator team that designed and developed the MyIBD platform, and this work was supported in part by Cincinnati Children’s Hospital Medical Center. Dr. Richard Kravitz was supported in part by National Institute of Nursing Research Grant R01 NR01393801.
    [Show full text]
  • Collapsing the Distinction Between Experimentation and Treatment in the Regulation of New Drugs
    File: LAAKMANN EIC PUBLISH.doc Created on: 3/30/2011 4:56:00 PM Last Printed: 4/7/2011 11:58:00 AM COLLAPSING THE DISTINCTION BETWEEN EXPERIMENTATION AND TREATMENT IN THE REGULATION OF NEW DRUGS Anna B. Laakmann* The explosion of scientific knowledge in recent decades has simulta- neously increased pressure on the Food and Drug Administration (FDA) both to expedite market entry of promising medical breakthroughs and to safeguard the public from harms caused by new products. Ironically, as the FDA and drug manufacturers spend huge sums in the premarketing phase gathering and interpreting data from planned trials, an enormous amount of valuable information about postmarketing clinical experiences with FDA-regulated drugs is not being effectively captured. The Article asserts that the FDA should formally recognize the blurred line between experimentation and treatment by adopting a more fluid approach to its review of new medical technologies. It argues that the FDA should shift its focus toward harnessing and distilling accumulated experiential knowledge about the effects of new drugs so as to enable patients and doctors to make rational treatment decisions based on inevitably imperfect information. The Article sets forth an alternative regulatory approach that seamlessly incor- porates prospective outcomes data into the FDA drug review process. This approach would be facilitated by the creation of a centralized database that serves as a clearinghouse of information about treatment outcomes. The proposed scheme would help to address current failures in the imple- mentation of the agency’s “fast-track” programs. More broadly, it could serve as the instrumentality to effectuate a shift in the perceived role of the FDA from market gatekeeper to consolidator and purveyor of information about drug safety and efficacy.
    [Show full text]
  • (EPOC) Data Collection Checklist
    Cochrane Effective Practice and Organisation of Care Review Group DATA COLLECTION CHECKLIST Page 2 Cochrane Effective Practice and Organisation of Care Review Group (EPOC) Data Collection Checklist CONTENTS Item Page Introduction 5-6 1 Inclusion criteria* 7-8 1.1 Study design* 7 1.1.1 Randomised controlled trial* 1.1.2 Controlled clinical trial* 1.1.3 Controlled before and after study* 1.1.4 Interrupted time series* 1.2 Methodological inclusion criteria* 8 2 Interventions* 9-12 2.1 Type of intervention 9 2.1.1 Professional interventions* 9 2.1.2 Financial interventions* 10 2.1.2.1 Provider interventions* 2.1.2.2 Patient interventions* 2.1.3 Organisational interventions* 11 2.1.3.1 Provider orientated interventions* 2.1.3.2 Patient orientated interventions* 2.1.3.3 Structural interventions* 2.1.4 Regulatory interventions* 12 2.2 Controls* 13 3 Type of targeted behaviour* 13 4 Participants* 14-15 4.1 Characteristics of participating providers* 14 4.1.1 Profession* Item Page Page 3 4.1.2 Level of training* 4.1.3 Clinical speciality* 4.1.4 Age 4.1.5 Time since graduation 4.2 Characteristics of participating patients* 15 4.2.1 Clinical problem* 4.2.2 Other patient characteristics 4.2.3 Number of patients included in the study* 5 Setting* 16 5.1 Reimbursement system 5.2 Location of care* 5.3 Academic Status* 5.4 Country* 5.5 Proportion of eligible providers from the sampling frame* 6 Methods* 17 6.1 Unit of allocation* 6.2 Unit of analysis* 6.3 Power calculation* 6.4 Quality criteria* 17-22 6.4.1 Quality criteria for randomised controlled trials
    [Show full text]
  • Patient Reported Outcomes (PROS) in Performance Measurement
    Patient-Reported Outcomes Table of Contents Introduction ............................................................................................................................................ 2 Defining Patient-Reported Outcomes ............................................................................................ 2 How Are PROs Used? ............................................................................................................................ 3 Measuring research study endpoints ........................................................................................................ 3 Monitoring adverse events in clinical research ..................................................................................... 3 Monitoring symptoms, patient satisfaction, and health care performance ................................ 3 Example from the NIH Collaboratory ................................................................................................................... 4 Measuring PROs: Instruments, Item Banks, and Devices ....................................................... 5 PRO Instruments ............................................................................................................................................... 5 Item Banks........................................................................................................................................................... 8 Devices .................................................................................................................................................................
    [Show full text]
  • MEDICAL COVERAGE POLICY SERVICE: Air Ambulance
    MEDICAL COVERAGE POLICY SERVICE: Air Ambulance Policy Number: 282 Effective Date: 05/01/2021 Last Review: 03/25/2021 Next Review Date: 03/25/2022 Important note: Unless otherwise indicated, this policy will apply to all lines of business. Even though this policy may indicate that a particular service or supply may be considered medically necessary and thus covered, this conclusion is not based upon the terms of your particular benefit plan. Each benefit plan contains its own specific provisions for coverage and exclusions. Not all benefits that are determined to be medically necessary will be covered benefits under the terms of your benefit plan. You need to consult the Evidence of Coverage (EOC) or Summary Plan Description (SPD) to determine if there are any exclusions or other benefit limitations applicable to this service or supply. If there is a discrepancy between this policy and your plan of benefits, the provisions of your benefits plan will govern. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. Unless otherwise specifically excluded, Federal mandates will apply to all plans. With respect to Medicare-linked plan members, this policy will apply unless there are Medicare policies that provide differing coverage rules, in which case Medicare coverage rules supersede guidelines in this policy. Medicare-linked plan policies will only apply to benefits paid for under Medicare rules, and not to any other health benefit plan benefits. CMS's Coverage Issues Manual can be found on the CMS website.
    [Show full text]
  • Revitalizing Health for All: Case Studies Of
    REVITALIZING HEALTH FOR ALL Case Studies of the Struggle for Comprehensive Primary Health Care While impressive medical and technological developments have im- proved health care around the world, improvements in health have been moderate and inconsistent across countries and communities. In response to this challenge, the World Health Organization outlined the concept of comprehensive primary health care, which involves not only providing a range of medical care from prevention to treatment, but also working to improve equity in health care access, community em- powerment, the participation of marginalized groups, and collabora- tion across sectors beyond health. Revitalizing Health for All examines 13 cases of efforts to implement comprehensive primary health care reforms in communities around the globe, including in Australia, Brazil, Democratic Republic of Congo, South Africa, and Iran. The case studies originated from an international research-to-action initiative that brought researchers and research-users from national public health systems together to design, implement, and assess local projects. This volume reveals the similarities among com- prehensive primary health care projects in diverse national contexts and offers a rich evidence base from which future reform initiatives can draw. ronald labonté is a professor in the Faculty of Medicine at the University of Ottawa and the Faculty of Health Sciences at Flinders University. david sanders is a professor emeritus and founding director of the School of Public Health at the University of the Western Cape. corinne packer is a senior researcher in the Faculty of Medicine at the University of Ottawa. nikki schaay is a senior researcher in the School of Public Health at the University of the Western Cape.
    [Show full text]
  • Wisconsin Emergency Medical Services System Overview; a Call to Action
    WISCONSIN EMERGENCY MEDICAL SERVICES SYSTEM OVERVIEW; A CALL TO ACTION Developed by EMS Stakeholders September, 2008 Approved by EMS Board 08/2008 EMS System Overview; A Call to Action EXECUTIVE SUMMARY The current state of the Emergency Medical Services (EMS) System and Trauma Care System are at risk of catastrophic failure. This document discusses the issues through a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the system. Primarily the following are the main findings: Strengths‐ These are generally categorized as the number of volunteers that provide care, the dedicated stakeholders/providers, various committees providing network opportunities, a developing hospital and trauma system, EMS educational system, progressive scopes of practice for all level of providers, and the current funding assistance initiatives. Weaknesses‐ identified as workforce issues, lack of stable funding to support development and structure, no increase in funding assistance dollars since its inception, poor communication of information through the EMS industry adding to inadequate representation, lack of DHS/DPH support, lack of regional EMS support, and the geography of service areas. Opportunities ‐ a potential legislative council study, building consensus through stakeholder initiatives and consortia, potential restructuring of the systems, infrastructure to educate and promote EMS & Trauma, developing EMS & Trauma data systems. Threats‐ include inconsistent and inaccurate messages to the public and government leaders, Public perception, other special interest groups, strong ethics of the workforce, lack of stable funding, open administrative rules, DHS/DPH Management, all of which are representative of a failing EMS & Trauma infrastructure. The SWOT analysis is found to be directly associated with the 2001 National Highway Transportation Safety Administration (NHTSA).
    [Show full text]