Why does EMS make less?

I was under the impression the terms could be used synonymously in terms of referring to organizations in the U.S. who operate a business (not a charity). I don't believe the IRS separates the terms in this case and a nonprofit organization is the same as a not for profit organization? Just a change in terminology, I don't know? I took a "financial anylsyis of EMS" class at the university 2 years ago but I really don't remember much of it ;-) http://www.idealist.org/info/Nonprofits/Basics1
 
I dunno, I was only speaking from personal experience and not a position of authority...and I have not started a church yet...err I mean a charity. :)
 
Ya you probably know more than I do about it. It was an interesting class, but if you don't use it you start to lose it.
 
akflightmedic said:
Not sure that is fair analogy.

Most taxi companies do a daily lease or 12 hour lease to the driver. The driver then has to share some of the fare with the taxi company. The driver also has to fuel the taxi.

The company carries the insurance and maintenance hence the ****ty insides of most taxis and rough rides. (Praise Uber).

In a sense, the taxi company has NO heavy payroll costs at least when discussing drivers as they are all typically contractors.
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I just chose taxi because it was the first thing that popped into my head, not because I thought the business models were necessarily a perfect comparison.

The point is, an EMS agency has a lot of overhead (expensive ambulances, medical equipment, drugs, hefty insurance) and plenty of personnel costs. However, unlike many other businesses, their revenue is at least partly if not largely dependent on things outside of their control. They have to provide service to people who can't or won't pay, and in fact those people may be a majority of their customer base. An EMS agency can consistently provide a great service and still have crappy reimbursement. No other type of business that I can think of has those problems.

Some places, paramedics do make really decent money. Those probably tend to be places that, for whatever reason, are able to receive a greater portion of what they bill.
 
Well look at it this way. Our department has an annual budget of $60 million and we return about $25 million of that in billing and all of that hoopla. Our fire department has a budget of just under $172 million dollars, and return roughly ZERO dollars. Our department is half the size and runs double the calls now. Guess who gets paid more. Its just a stigma thing, until each agency raises its hiring standards and becomes more exclusive like fire and police we will not be paid as well.

Granted some police and fire departments make squat, but I am just going off the decent sized cities.
 
SandpitMedic said:
I think the whole... Privates don't get reimbursed enough is kind of a hogwash. Admittedly, they probably don't get what they should. That said, I've never met any poor or middle class ambulance company owners....
I think they do alright, or there wouldn't be the large market.

Envision - for example - made like 6 billion in profits last year (and I am aware they dabble in other markets too, no need to make it a big ol deal). And every small ambulance business owner I've met is a ****ing millionaire...

So.... That's my take on that aspect. Wages cut into profits, and with a sea of folks willing to do it do free or for pennies.... Well... Supply and demand.

You guys know - I've been fired up on this topic before. Then I learned here on this very forum, the economics of it trump the "I deserve more for being a hero" mantra.

They could start reimbursing 100% tomorrow. No one will get a raise. Lol.
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The reimbursement rate for 911 ambulance services is incredibly low, regardless of model. Realistically, until there is some sort of overhaul in how EMS gets reimbursed for providing its services, we are not going to make any more money. The money is just not there.
ExpatMedic0 said:
In terms of the profits and reimbursement argument, it is a possibility, and medicare medicaid aren't exactly cash cows. However, does anyone here have any actual accounting experience for an EMS agency, or even EMS management experience where they have at least seen a "balance sheet"? From what little education in EMS finance and management I have (and keep in mind, I have zero experience), it seems to me that stakeholders and upper management take a much larger chunk of the revenue than mere field employee's get when you analyze the assets and how they are redistributed. Even in "not for profit" organizations, you would be surprised how this money can be redistributed and allotted.
From my experience, an ALS ground transport normally bills at least about 1000 USD at a "non profit" private agency. So how much does a respiratory therapist working for a "non profit" hospital bill for a 30-60 minute patient interaction? How much does a fire department bill for responding to a an issue taking about this much time? Their salary seems to be 25-50% higher than mine on the west coast, is the employer getting reimbursed more for their calls?
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I do many of my agency's grants so I am familiar with our financials. As stated, the amount of overhead is very high when compared to what is billed, never mind what is actually recouped. Our chief (we are tax funded but our own entity) makes a fair bit more money than our field providers. But even if his compensation went down to just slightly above our captains (which we can't, because we need him), we would not be saving a significant portion of money. Even if we redistributed 30k to our employees, it still would amount to less than a dollar an hour raise. So for many agencies, saying the boss makes too much money at the crews expense isn't accurate.
 
I don't know if all that is necessarily true ,Unless you are just talking about Basic EMT. As a Paramedic, I get paid more than the cops around here. if I worked for a fire based service, as a fireman/medic I'd get paid more than just a fireman. If you worked for a private agency here you would make more as a Paramedic than both the cops and fire guys make. I work as a Paramedic in hospital, I'm strictly weekend nights so I max out on the differentials. My fiance is a day shift nurse, we make just about the same money.
 
phideux said:
I don't know if all that is necessarily true ,Unless you are just talking about Basic EMT. As a Paramedic, I get paid more than the cops around here. if I worked for a fire based service, as a fireman/medic I'd get paid more than just a fireman. If you worked for a private agency here you would make more as a Paramedic than both the cops and fire guys make. I work as a Paramedic in hospital, I'm strictly weekend nights so I max out on the differentials. My fiance is a day shift nurse, we make just about the same money.
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Wow, thats great. What area of the country is this? You work as a paramedic for a hospital who also uses you for transport service, or inside the hospital itself?
 
ExpatMedic0 said:
Wow, thats great. What area of the country is this? You work as a paramedic for a hospital who also uses you for transport service, or inside the hospital itself?
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I'm in South Carolina. I don't do transport for the hospital, I work in the ER, which is a trauma center. They use Paramedics as a supplement to the nursing staff.
 
phideux said:
I'm in South Carolina. I don't do transport for the hospital, I work in the ER, which is a trauma center. They use Paramedics as a supplement to the nursing staff.
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Well you let the cat out of the bag. Even Donald Trump can't build a wall high enough to keep us out, we're all moving to South Carolina ASAP!
 
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