Paying for Emergency Medical Services: Readiness versus Utilization

paying for emergency medical services

When a 911 operator answers a call, the person on the other end of the line is often nervous and seeking immediate help. Much like the first responders who don’t hesitate to rush to their aid, most callers don’t pause to consider the cost of the emergency medical services they need or their ability to pay for them. 

The inability to recoup losses for percentages of ambulance billing is only one of many factors to consider when developing emergency services for your city.

Upfront Costs: The Price of Being Ready

The price tag on a single, fully-stocked ambulance starts at $300,000. This figure doesn’t account for the facility to house it  – often with the local fire department – or the highly trained crew needed to operate it at a moment’s notice. Depending on the size of the city, municipality, or county in need of an EMS outfit, the cost of providing life-sustaining services to its citizens rises exponentially. 

Where is this funding sourced? And what does it realistically cover?

In general, local taxes or bonds fund public EMS services. Citizens often vote on the percentage allocated to their local EMS providers to provide ambulance transportation and ambulance services. This funding source usually goes only so far, though, as there are usually both written and unwritten caps on the tax dollars available. 

Even if a city or county raises enough money to establish an EMS service, the figure still doesn’t account for the cost of round-the-clock availability and regular deployment. When residents or visitors find themselves in need of emergency services, the real cost of sufficient ambulance transportation is actually much higher.

Utilization Costs: The Price of Saving Lives

An ambulance crew responding to a call about someone suffering from a heart attack doesn’t run a credit check or ask about an insurance plan when they arrive on the scene.  Instead, they focus on utilizing every tool at their disposal to address the medical condition, stabilize the patient, and save their life.  In the heat of the moment, first responders aren’t concerned about whether or not they’ll eventually get paid for their services. For these very reasons, emergency medical services rarely, if ever, break even. 

Unfortunately, changes are coming that could further impact the revenue streams that EMS agencies do regularly manage to collect at present.

Changes Affecting Payments from Commercial Insurance Providers

Insurance companies already make highly conservative determinations regarding what medical services they cover and the rate they offer to pay for them. Legislation granting these commercial insurance providers even more freedom of choice concerning service coverage and price is currently up for discussion.

If adopted, the legislative changes proposed could significantly decrease the already insufficient incomes on which emergency medical care providers in Texas and across the country have come to rely.

Changes in Patient Population

Most people aren’t ready with an intricate action plan when they make that call to 911. The situation at hand often catches them completely unprepared. Only a minority of Americans have savings set aside specifically for medical emergencies, and many are already underserved when it comes to regular health care. It’s a fair assumption that most hope they will never have to call an ambulance.

Socio-economic factors like our aging population and volatility in the national employment level impact the average citizen’s ability to pay for unexpected EMS services. Many EMS agencies offer policies to help patients manage any medical bills they incur from EMS services. These policies extend to non-citizens as well. Regardless, the current circumstances are making it increasingly difficult for patients to cover the cost of their care.

What’s an EMS agency to do? While all of this may sound disheartening, there are strategic steps that EMS providers can take to recoup as many of their costs as possible. To learn more about the measures you can put in place to protect your revenue, contact us at

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