Improving Transparency and Oversight of Emergency Medical Services in Minnesota

Abstract

During the project, the scope of consideration was broadened to include the findings of interviews with EMS professionals stating desired reforms and challenges. Desired reforms included the establishment of performance standards for EMS delivery, recalibration of the Emergency Medical Services Regulatory Board (EMSRB) composition to increase more diverse professional representation, increased opportunities for local input in EMS management, the need for connection and engagement between EMS professional and the communities they serve, and increases in pay and professional acknowledgement commensurate with the services provided to the community and equivalent medical professionals in other settings. A number of challenges were also identified. This included the ongoing shortage of paramedics and EMS professionals to provide EMS coverage, exacerbated by the increasing pressure on EMS to support the needs of an aging population. Other challenges also include a lack of local control in EMS decision making; inequitable payment and reimbursement systems that do not compensate for services provided by onscene and non-transporting EMS ; little to no quality measurement indicators (QMIs) leading to lack of performance improvements; low volunteerism; low Medicare/Medicaid reimbursement rates; and the diversion of ambulances for use as non-emergency medical transportation. . The Research Policy Team found that there are multiple factors that need to be addressed in order to address the ongoing challenges and necessary reforms. Complicating factors include the complexity of the policy space; a lack of consensus on problems and priorities; the need for more work to engage community & stakeholders in decisions making; and the lack of diversity on the EMSRB. The reality is that as the need for EMS continues to grow so will the complexity of the challenges.