How do ambulance operations work?

[patzyboi]

Regarding contracts, with counties, hospitals, etc.

How do they get contracts with hospitals, and if they do, that means that they spend most of their work with that hospital?

How about county? How does a company get a 911 contract? I heard about bidding, and how does that work? Does that mean a list of companies put their name on a list, and the county chooses one?

 

[Aprz]

I'm sure it's more complicated than what I say, but I think ambulance companies will write a list of promises, the hospital or county might say what they want, and agree on a price. If the ambulance company gets the contract, they'll usually respond to that hospital. In you area,

Sutter Summit Pavilian, Alta Bates, Stanford/LPCH - ProTransport-1
VMC, Doctors - Westmed
Regional (and I think Washington) - Royal
St. Rose - Norcal
Kaisers in Santa Clara, Alameda, and Contra Costa County - Rural/Metro

911 in your area,

Santa Clara County - Rural/Metro
Alameda County - Paramedics Plus
Contra Costa County - AMR

A least for these county biddings for 911, the put a lot of the documents and agreements online. When I get home, I'll post a link to it so you can see what they discuss.

Not all areas work like this. I've been in areas where you start an ambulance company, the county draws a little border around your station, and says that you have to respond to 911 calls within that border so you might see multiple ambulance companies responding to 911 calls in the county.

Also if there was a fire department doing transport before counties were given the responsibility to deal with EMS, those fire departments can continue transport. Examples are Albany, Berkeley, San Ramon, Alameda, Piedmont, and Palo Alto Fire. From what I am told, it's difficult to get fire to do transport because it's the cities that got to agree on it. A lot of counties don't have funding for EMS cause they are only able to tax limited things too. Another issue is that Fire would no longer be able to do dual role since they'd be outra service for awhile cause of transport.

Edit Here is a link to all the information on the bidding in Alameda County.

http://www.acphd.org/ems/about-ems/paraplus.aspx

 

[MMiz]

There are different types of contracts for different types of services.

When a county or city puts an ambulance contract out for bid they specify everything they want in the contract and usually the lowest bidder wins. Usually companies are evaluated and pre-qualified prior to the submitting a formal bid, but the company that submits the lowest cost for services wins.

In the case of a private company that isn't changing a municipality, usually applicants are scored based on promised services.

With hospitals and private facilities I found that it was actually much more casual. It's more of a formalized agreement between the service and the facility.

A company I worked at used to transport 75% of the patients from one hospital. We were practically that hospital's EMS service, though there was nothing formal in place. AMR come in one day and offered the hospital a guarantee that within x minutes of requesting an ambulance transport the patient would be packaged and out the door. AMR would also station a staff member to pre-package the patient, get the paperwork, and a baseline set of vitals to expedite EMS transport. We lost a lot of our business when that happened.

Public agencies are required by law to put a contract out for bid, whereas private companies can follow their own internal process.