Many rural areas are served by low-volume Emergency Medical Services (EMS) providers. By definition, these providers are high-cost providers because the costs of capacity cannot be spread over a larger number of EMS transports. Revenue sources of low-volume providers are varied, and the Medicare Ambulance Fee Schedule may be changing revenue for many providers. Under this environment, there may be strong incentives for the rural hospital to acquire an ambulance or local EMS provider. The purpose of this project was to clarify issues surrounding the hospital's decision to acquire and maintain ownership of community ambulance services. Advantages and disadvantages of ownership are identified and analyzed, both conceptually, and informed by key informant interviews with CAH staff.

Publications

• Experiences of Critical Access Hospitals in the Provision of Emergency Medical Services (Policy Brief)
  NORC Walsh Center for Rural Health Analysis
  Date: 10/2008
  This brief presents research conducted to better understand critical access hospitals' (CAHs') experiences in operating emergency medical service (EMS) units. The benefits and challenges that CAH providers face in operating EMS services are discussed.