2024 EMS Trends from 14 Industry Leaders

01
2024
EMS Trends from
14 Industry Leaders
2024 EMS Trends from 14 Industry Leaders

02
Dale Loberger.
MARVLIS Consultant,
BCS; FTO, Union EMS;
Captain, GRVFD.
Greg Friese.
Editorial Director,
EMS1
Kevin E. Frisch.
CEO, Banquest
Payment Systems.
Brian Werfel.
Partner, Werfel &
Werfel
Maggie Adams.
President, EMS
Financial Services.
Chris Cebollero.
President & CEO,
Cebollero &
Associates.
Scott Moore.
Senior Consultant &
Show Host, Moore
EMS Consulting.
Robbie MacCue.
Co-Founder, EMS
Leadership Academy.
Assistant Chief of EMS,
Town of Colonie.
Samuel Scheller.
CEO, Guardian Elite
Medical Services (NV).
Mike Taigman.
Author of Super-
Charge Your Stress
Management in the
Age of COVID-19.
Joshua D. Hartman.
Senior Vice President,
Cardiovascular &
Public Safety Divisions,
HMP.
Mark Tenia.
Public Relations/Media
Manager, Richmond
Ambulance Authority.
Omar Masri.
CEO, Mamori.io.
Nancy Magee.
EMS Educator,
consultant, conference
speaker at MEDIC
Training Solutions LLC.
Contributors

03
Expect Greater
Legislation in Balance
Billing Restrictions
Last year, I predicted that we would see a greater push at the
state level to expand the consumer protections against surprise
medical billing. At the time, I noted that the Federal No
Surprises Act exempted ground ambulance services from those
restrictions. The practical effect was to leave us as the only
major health care industry that could continue to balance bill
patients. I noted that there was proposed legislation in a
number of states that would ban balance billing for ground
ambulance services. In 2023, we saw balance billing
restrictions enacted in California, Louisiana, and Texas. These 3
states represent more than 20% of the nation’s total
population. When you consider states with pre-existing laws,
nearly 1 out of every 2 Americans resides in a state that
restricts balance billing in whole or in part. I expect this trend
will continue in 2024, with bills pending or expected to be
proposed in several additional states.
01
Brian Werfel
Partner, Werfel
& Werfel

04
Look to Maximize
Productivity by
Automation
Last year, I foresaw rising EMS costs. This year, this is even more
true. With labor costs surging on a year-on-year basis, smart EMS
providers should be looking to maximize productivity of existing
teams by implementing greater efficiencies and automating
processes rather than increasing headcount.
Utilizing a software like Traumasoft for only one part of your
process but utilizing other systems to handle the other processes
slows down operations and increases room for error. For the
greatest workforce optimization, operators should invest the
time to learn all the capabilities, functions and integrations that
technologies like Traumasoft offer and put them into
operation. It may be a learning curve at first but the ROI will be
significant and long term.
02
Kevin E. Frisch
CEO, Banquest
Payment Systems

05
A Focus on Employee
Satisfaction will
Continue
A focus on employee satisfaction will continue.
Well-publicized criminal trials for wrongful deaths involving EMS
are likely to chill the already anemic growth of new and much
younger providers as even more experience retires in 2024.
Regardless of the legal outcomes, the anticipated churn of staff
will direct administration attention toward further automation
and searching for strategies to reduce personnel stress levels.
03
Dale Loberger
MARVLIS
Consultant, BCS;
FTO, Union EMS;
Fire Chief, GRVFD

06
Artificial Intelligence
will Change EMS
Artificial intelligence, including large language models like
ChatGPT, will lead to a range of subtle to revolutionary changes
in EMS. Everything from how EMS is dispatched to patient care to
communication to the hospital to completing the electronic
patient care report will be impacted by rapid advances in AI. In
addition, initial education programs and continuing education
organizations will need to rethink how students are taught and
evaluated. The impact of AI on EMS will be as significant, if not
more significant, on every field provider, educator and leader as
access to the internet was 30 years ago.
04
Greg Friese,
MS, NRP
Editorial
Director, EMS1

07
Good Use of Employee
Data can Help Lower
Turnover
EMS leaders will be best served by viewing their organizations
through the eyes of their team members. Those who focus on
improving the team member’s daily work environment will
experience higher levels of employee engagement and lower
turnover. The key will be to analyze and leverage the massive
amounts of organizational and employee related performance
data captured in our various platforms. In 2024, data integration
will help managers lead more human focused organizations.
05
Scott Moore
Senior Consultant
& Show
Host, Moore EMS
Consulting

08
Providers would be Wise to
Perform Internal Audits on
Their Medicaid Documentation
One of the biggest areas where ambulance services will see change is the opportunity for
relationships with other healthcare players involved in community
paramedicine/mobile integrated healthcare. CP/MIH options will grow throughout the
country which means there needs to be a way to be reimbursed and compensated for
these services. CP/MIH services need to document the social determinants of health
(SDOH) presented by their patients while billers need to code those SDOH issues on
claims. There will be new working opportunities with telehealth providers, home health
services, and behavioral and mental health organizations. It will be essential that
providers have good metrics on their responses and the SDOH problems they encounter
as third-party payers are very committed to responding to these type of
patient/community needs. The best route to payment for CP/MIH providers will be the
depth of their data. While we look to the future of CP/MIH, the traditional world of EMS
and ambulance services still needs attention. The next year will see continued growth
towards managed care and away from fee-for-service for Medicare beneficiaries and
Medicaid recipients. Medicare Advantage plans now cover over 50% of the Medicare
population. Providers need to understand the different regulatory issues related to
Medicare Advantage reimbursements (particularly for non-emergency services which
may require in-network participation). Since these plans are funded with taxpayer
dollars, providers can anticipate ongoing audit activity related to Medicare
Advantage. Medicaid fraud oversight has already ramped up and will continue to do
so. Providers would be wise to perform internal audits on their Medicaid
documentation and billing (including claims sent to Medicaid managed care plans).
Medicaid compliance will be a hot topic going forward.
06
Maggie Adams
President, EMS
Financial Services

09
It May be Time to Get Back
the Dual EMT Basic Trucks
with ALS Intercept
While Mobile Integrated Healthcare and Community
Paramedicine is still the future of EMS, leaders now need to
focus on a different system design. In the past, dual paramedic or
paramedic/basic trucks were the gold standard, the system of the
future needs to be redefined. As we combat a workforce
shortage, it may now be time to get back the dual EMT Basic
Trucks with ALS intercept. One of my first civilian jobs in EMS was
as an ALS intercept medic in Massachusetts. 911 response would
be a Basic EMT response, and if I was needed, I would be called
in. This design would allow systems to train up the EMT basic skill
set, giving them more knowledge, skills and abilities to take care
of patients safely. There are EMS systems today that are using
versions of this model with great success. Time to take a step
back into the past to secure our future.
07
Chris Cebollero,
NRP
President &
CEO, Cebollero &
Associates

10
EMS Professionals are
Increasing Part of the
Overall Healthcare System
EMS World Expo 2023 held in New Orleans, LA was a tremendous success. Much of the
success is due to the educational programming that we provided which more than ever
reflected the breadth and depth of prehospital and out of hospital care performed by EMS
professionals. We conducted a large scale mass casualty incident (MCI) exercise at the
SuperDome in conjunction with our colleagues from New Orleans EMS and Acadia where
we simulated in ‘as real as possible’ ways how to care for the immediately and
catastrophically injured patients. This training was taken home to participants from around
the world to improve their responses to the unfortunately increasing number of these
incidents. We also focused on the delivery of blood products to the field which though not
yet standard of care, due to cost and logistics, is clearly a promising therapy for those
patients with significant blood loss in the field, given our current treatments of fluid
resuscitation, pressors and/or TXA have not moved the needle in this area. We also focused
on Ketamine which has been both seen as somewhat of a panacea by some and
controversial by others. We reviewed the science, its indications for use, including
recommended dosing as well as when Ketamine may not be the right choice as well as a
review of multiple incidents in which Ketamine was used that made the news. Additionally
we did a deep dive into the opioid epidemic and the EMS response – from alternate
transportation destinations to mobile integrated health responses, to naloxone leave
behind programs and creative ways to help address the problem affecting our communities
and our EMS departments. It is clear that EMS professionals are increasingly part of the
overall healthcare system, as the true gatekeepers to much of the patients who access
healthcare globally. They are stepping up to the plate using evidence-based therapies to
improve worldwide healthcare for hundreds of thousands of patients each year.
08
Joshua D.
Hartman,
MBA, NRP
Senior Vice
President,
Cardiovascular &
Public Safety
Divisions, HMP

11
Artificial Intelligence is
the Biggest Disruptor
ARTIFICIAL INTELLIGENCE IS the biggest disruptor in our world in
general and EMS. We are just scratching the surface for how it
might help us improve diagnostic accuracy, strategic planning, and
performance improvement.
09
Mike Taigman
Author of Super-
Charge Your Stress
Management in
the Age of COVID-
19

12
EMS Leaders have Two
Great Opportunities in
2024
Leaders have two great opportunities in the new year to leverage their recent experiences and add immense value
back into their organizations that will improve viability and organizational culture.
1. Leverage their experiences over the last four years of this pandemic to educate elected officials at all levels,
starting with the local officials who control the budgets.
With record breaking turnover numbers seen across the country, and utilizing the AAA / Newton 360 turnover study
to quantify direct turnover costs (around $9,100/person at an average of 25%), agencies can show the business case
for investing in their personnel to retain them and reduce direct turnover costs.
Utilizing emotionally connecting stories of their constituents, providers and patients, that connect to these numbers
will demonstrate the real-life impact and have a greater likelihood of shifting perspectives.
2. Invest in an asset that will appreciate in value with time. Leadership development does not have to be seen as
a luxury. You have the ability to build a bench of leaders before they are thrust into a leadership role. By investing
in your most important asset (people) it will communicate what your agency values — and you will see a much
bigger return for your agency’s future.
There is a direct correlation between the leadership of an organization and the rate of turnover. Leadership is not a
title; it is an action. Being a great provider doesn’t equate with being a great leader. It is essential to invest in
leadership training to ensure a thriving, sustainable organization.
—
Robbie MacCue, FP-C, MBA, and Lisa Giruzzi are the founders of the EMS Leadership Academy and hosts of the EMS
Leadership Summit, an annual virtual conference attended by thousands from around the globe. Robbie brings
extensive experience in EMS leadership and holds a master’s from Case Western Reserve University’s Cleveland
Clinic program. Lisa, with over 25 years as a trainer and executive coach, specializes in empowering EMS leaders to
create sustainable organizations. For more information,
visit www.EMSLeadershipAcademy.com and www.EMSLeadershipSummit.com.
10
Robbie
MacCue,
MBA
Co-Founder, EMS
Leadership
Academy.

13
Advancements in
Medical Technology and
Artificial Intelligence
I see artificial intelligence and advancements in medical
technology, such as portable diagnostic tools, wearable devices,
and communication systems enhancing the capabilities of EMS in
the field.
11
Samuel
Scheller,
MBA, NRP
CEO, Guardian
Elite Medical
Service (NV)

14
Rising EMS Costs,
Revenue, and Solvency
are Major Concerns
As large private for-profit enterprises exit rural and suburban areas where cost
of EMS provision exceeds potential profit, communities will have to face the
music on the cost of EMS response-including the cost of readiness. Endangered
nonprofits including volunteer and hybrid agencies need to be prepared to
provide their local government with accurate data reflecting projected future
cost of providing 911 response. This includes but is not limited to skyrocketing
material expenses, the necessity of paying a living wage to career staff in order
to recruit and retain a competent labor force, and the impact and monetary
value of volunteer time. The shortfall that exists between insurance revenue
and solvency must be addressed. Communities will have to make an informed
choice on what they are willing to pay for and determine how to pay that
subsidy- or be resigned to the possibility of not having any service at all.
Most of the work has been done here-so use it!
Publication Details: A Consensus Panel Approach to Estimating the Start-Up and
Annual Service Costs for Rural Ambulance Agencies – Rural Health Research
Gateway.
This is our chance to get it right or accept the collapse of the entire EMS system.
12
Nancy Magee
EMS Educator,
consultant,
conference
speaker at MEDIC
Training Solutions
LLC

15
Strategic Communication
will Continue to Play a
Large Role
Strategic communication will continue to play a large role in
gaining support from the public, elected officials and
stakeholders. The pandemic exacerbated many of the issues EMS
agencies across the country were facing, accelerating the need
and push for creative solutions. It also presented an opportunity
to educate the communities we serve about the challenges we
were dealing with, how we got there and what the industry as a
whole would need moving forward. I believe we will see an even
greater focus at the federal, state and local level to communicate
strategically to each audience in an effort to garner adequate
support. We have seen a growing number of EMS leaders
realizing the important role communication plays in the
advocacy for EMS and that is a trend that will continue with
fervor in the coming year.
13
Mark Tenia
Public
Relations/Media
Manager, Richmo
nd Ambulance
Authority

16
Cybersecurity Will
Continue to
Challenge EMS
A major trend I see is that there is a perfect storm brewing to
challenge EMS organizations both economically and
organizationally. First, you have Health insurance providers and
government regulations squeezing transport provider
revenue. Second, you have rising inflation increasing operational
cost and staff stress levels, and finally you have the unrelenting
growth of cyberattacks aimed at extorting money from EMS
organizations and disrupting business continuity.
At Mamori.io we recognize that running an EMS organization is
becoming increasingly challenging and stressful, and that is why
we are focused on helping EMS organizations protect themselves
from modern cyberattacks with a comprehensive, easy to deploy,
and cost-effective cybersecurity and ransomware protection
solution. Our mission is to remove the stress of cybersecurity
from EMS business owners. Traumasoft is using Mamori.io to
secure its valuable data, and we are happy to help all their
partners and customers do the same.
14
Omar Masri
CEO, Mamori.io

About
Traumasoft
Traumasoft is one truly integrated product for
Emergency Medical Services (EMS) that drives timely
efficiencies. We are an all-in-one system capable of
managing every aspect of your EMS operations. One
system comprised of interconnected solutions handles
staff, integrates processes, manages assets, and grows
revenue.
Schedule a demo today at
https://traumasoft.com/request-demo/ to see how we
can help you increase operation efficiency and
profitability.
17

Phone:
866.245.2692
Corporate Headquarters
1111 W. Centre Ave.
Portage, MI 49024
Fax:
269.585.5901
Email:
info@traumasoft.com
contact us
website:
https://traumasoft.com
18

2024 EMS Trends from 14 Industry Leaders

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Editor's Notes