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How Much Does EMS First Response Really Cost??

How Much Does EMS First Response Really Cost??. ‘Economic Modeling 101’. Presenter : Matt Zavadsky, MHA EMS Director, Volusia County Florida Adjunct Faculty, University of Central Florida College of Health and Public Affairs. Why is this Important?. Increasing budgetary constraints

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How Much Does EMS First Response Really Cost??

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  1. How Much Does EMS First ResponseReally Cost?? ‘Economic Modeling 101’ Presenter: Matt Zavadsky, MHA EMS Director, Volusia County Florida Adjunct Faculty, University of Central Florida College of Health and Public Affairs

  2. Why is this Important? • Increasing budgetary constraints • Need to justify and/or benchmark against others or self over time • Recent research questioning value of pre-hospital ALS • OPALs Study - 2004

  3. Why is this Important? • Inter-jurisdictional issues • Mutual Aid, Automatic Aid • Contract for services • Inter-agency considerations • Fees for First Response to slow ambulance response times?

  4. Models Available... • Federal Emergency Management Agency Fee Schedule • Percent of Budget • By Incident • By Time on Task • Cost per Response • Fully Allocated • Marginal

  5. Models Available... Glad to be in FLORIDA • Cost per Unit Hour • Fully Allocated • Marginal

  6. “FEMA Model” • Fee schedule based on apparatus costs + actual personnel costs • Typical call = $37.50 • $35 {engine} + (2 {people} X $20/hour) X 0.50 hours • PROS: • All agencies accept this rate for reimbursement already • CONS: • Some feel this is underestimated and only accepted because nothing else is offered

  7. Why Men Should NotBaby Sit

  8. Percent of Budget Method • Percentage of time and/or resources used compared to the agency total budget • % of time on calls • X the agency’s total budget • PROS: • Compensates for ‘opportunity cost’ • CONS: • Difficult calculations • Rewards inefficiency

  9. Percent of Budget MethodIncident - Based

  10. Percent of Budget MethodTime - Based Time Available = Units x Hours on Duty 5 x 8,760 = 43,800

  11. Tax Based Method(a.k.a. - Insurance Model) • Cost based on the ad valorem millage for the contracted area • PROS: • Covers full costs of coverage (cost of readiness) • CONS: • Can only be used for sole response contracts • Negates cost shifting for areas with lower property values • Extremely difficult to determine reciprocal value in a municipal district without specific fire millage

  12. Tax Based Method(a.k.a. - Insurance Model)

  13. Unit Hour Cost Method • Total hours primary response units are available for calls • 1 unit 24 x 7 = 8,760 hours • 5 units on duty = 43,800 Unit Hours • Budget = $5,100,000 • $5.1 million / 43,800 = $116.44 per unit hour

  14. Unit Hour Cost Method • For an EMS Call: • 1 Unit X 0.40 hour = $46.40 • For a Structure Fire: • 3 units X 3 hours = $1,047.96 • PROS: • Easy to calculate • Allows for multiple unit reimbursement • Allows for time specific reimbursement • CONS: • Some feel $ is too low

  15. Is Your Brain Still Here??

  16. Cost per Incident Method • Total Budget / Total Incidents • $5,100,000 / 5,233 = $974.58 per incident • PROS: • Super easy to calculate • CONS: • No factor based on type of incident and resource use • 20 minute - single unit EMS vs. 5 unit 4 hour fire • Rewards inefficiency • Higher budget and few calls = high cost/incident

  17. Cost per Incident Method • “Normalize” based on countywide stats

  18. Summary Models...

  19. Summary Models...

  20. Examples from YOU...

  21. Things are Not AlwaysWhat they Appear... Be diligent in any cost analysis

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