Services are struggling to attract and retain talent. According to the 2022 Ambulance Industry Employee Turnover Study, EMS agencies experience a turnover rate of 24-36% each year, and many services report having as many as 30% of their positions unfilled.
The Influencers of Retention in the Minnesota EMS Workforce report indicates 21,000 credentialed EMS providers in Minnesota let their licenses lapse since 2017; many are young people under the age of 40.
Those leaving EMS identify low compensation to be a leading factor in their decision to leave. Below-cost reimbursement rates leave EMS services unable to increase wages as, unlike other businesses, we cannot simply raise rates and pass the cost on to the consumer.
Additionally, fewer workers mean more overtime for the dedicated providers who do stay, which contributes to provider burnout and the inability to find a work/life balance.
Ground ambulance providers respond to calls for help and provide immediate access to health care for all, regardless of their ability to pay. This is especially important in rural, underserved areas of the state. Many of these ground ambulance providers are in jeopardy because of the very low volume of services and reimbursement rates that are not based on cost.
One of our top priorities, a Medicaid supplemental payment program for EMS, would bring much-needed increased reimbursement to our non-governmental EMS services that do not enjoy the benefits of the current Intergovernmental Transfer (IGT) program. This additional funding would allow services to increase employee wages, increase access to equitable care through innovation, replace or upgrade patient care equipment, and take advantage of continuing education and professional development opportunities.
MN EMS systems have thrived in a collaborative, not competitive, atmosphere due to the Primary Service Area (PSA) law that has been in place since 1970. The PSA law ensures 24/7 coverage across the state and encourages a collaborative, systems-based approach to pre-hospital care while allowing organizations to invest in infrastructure over time.
The No Surprises Act, and interest in implementing balance billing prohibitions at the state level further threaten our industry's ability to cover the cost of providing care through reimbursement. The consequences of getting the balance billing policy wrong for ground ambulance services are dire and would increase the pace at which communities are losing access to these critical services. Ground ambulance services are often the only lifesaving and sustaining option for those in need and must be preserved and their unique market realities should be considered.
The health and safety of our front-line providers is a top priority. Not only are they exposed to potentially dangerous situations and infectious diseases regularly, many experience provider fatigue, burnout, and other mental health concerns..