Hospitals have to be very careful in this area especially when there are competitive situations.
Recent article:
Illegal Redirection of Ambulances Investigated in Calif.
http://www.emsresponder.com/web/onl...n-of-Ambulances-Investigated-in-Calif/1$12827
While nothing has been proven yet and the investigation is still ongoing, it could mean hospitals will be more cautious. Back in the 1980s when ambulance services became very competitive, ambulances were taking patients to the hospital "they liked better" because of the perks. It was also known that you took patients with insurance to one hospital and self-pay went to another. For doing so, the hospital that preferred only insurance patients would reward the EMS crews with BBQs and pizza parties. Eventually it led to the counties and the ambulance services enforcing the "nearest facility regardless" policy and took certain decision making out of the hands of the EMS providers.