Mayor Michael Bloomberg appears to be trying to convince people that he really does not understand business.
New York City will begin charging private hospitals as much as $1 million a year for hospital ambulances dispatched by the city’s 911 system, a controversial initiative that some medical professionals fear will prompt hospitals to stop providing the service.
The Fire Department has agreements with 25 private hospitals to provide voluntary ambulance services in the five boroughs. These hospitals account for roughly 37% of the ambulance tours in the city.
Beginning in January 2012, the administration plans to charge these hospitals fees based on the number of scheduled ambulance tours they operate in the 911 system. The annual fees are expected to range from about $73,000 to $1 million per hospital.
The trick is in charging enough to
make some money lose less money, while not encouraging the hospitals to decide that EMS is not a profitable business to be in.
“The 911 system cost-sharing initiative would allow the city to recoup the costs associated with 911 system dispatch and telemetry that are currently borne by the city, namely, the costs associated with the staffing and operation of the Emergency Medical Dispatch Center and Online Medical Control (Telemetry) center,” John Peruggia, FDNY’s chief of EMS command, wrote to one of the hospitals.
I have a suggestion for cost savings on their Online Medical Control (Telemetry) center. Scrap it. Make doctors available for consultation on an as needed basis, rather than all of the Mother-May-I? that requires this system. Of course, that means that medical directors should be paid more to provide aggressive oversight for EMS. Online Medical Control is not oversight.
Frank Gribbon, a spokesman for the Fire Department, said the hospitals benefit from bringing in patients. The city views the fee as “cost sharing.”
“The goal here is not to drive anybody out,” he said. “The goal is to share the burden and the cost.”
How many of the hospitals will just decide that they do not want to share this cost?
The city has 967 eight-hour ambulance tours scheduled every 24 hours. Of those the Fire Department handles 614 of the tours and the private hospitals’ ambulances handle 353 of them. If the private hospitals were to drop out of the system, the city would be forced to pick up the slack or sign agreements with other institutions to meet the demand.
If FDNY were to hire to cover all of those tours, that would be almost 400 new employees. Let’s assume a cost to NYC of $100,000.00 per employee per year.
How much is that going to
save cost NYC?
Last month, the mayor unveiled $585 million of new budget cuts in the current fiscal year and $1 billion for the following fiscal year. Charging the hospitals these fees will save $8.7 million annually.
If my math is close, that would be about $40 million annually and the hospitals would not even be paying this fee. Rather than saving $8.7 million, they would be adding $40 million – we should also include the cost of new ambulances and supervisory personnel.
Maybe NYFD won’t hire to cover the openings, but will just work the current ambulances and employees harder. Then there is the option of saving money by paying overtime to staff the ambulances. This may work in the short term for both employees and the agency, but after a while extra pay is not worth it. The burn out leads to bad patient care and increased turn-over. Wimps – just work a measly 40% harder each week.
Look at Philadelphia. In order to protect their nonsensical residency rule, they are several hundred medics short. Their responses sometimes require them to travel across the entire city. But they can brag that all of their paychecks go to people who live in the city. With a patch, a pulse, and a Philly address, who cares about quality?
I would be cynical, if I were to suggest that politics is dramatically more important than quality of care in Philadelphia, so I won’t suggest that.
Take a look at the way NYFD pays EMS. Clearly, FDNY takes EMS seriously.
Basic EMT – $31,931 to start.
A major factor driving up the city’s poverty rate was the cost of housing, which has remained relatively high despite the real estate collapse. To account for the cost of shelter, city officials raised the poverty threshold for a family of four by nearly 25 percent, from an annual income of $24,353 in 2005 to $30,419 in 2008. The federal threshold in 2008 for a family of four was $21,834.
After a 5 years of this, how many people are going to decide that they are sick of being run into the ground. Time to abandon EMS for the fire side? Probably not that easy, but there won’t be much pay to give up to move to some other EMS agency that pays better and is in a location with a lower cost of living, such as Chappaqua.
After 5 years as an EMT for FDNY – $45,834.
After 5 years as a firefighter for FDNY – $76,488.
What a wonderful way to let EMS know that they are valued. Working on an ambulance handling several times as many calls as those working on a fire truck, but for poverty level pay that is laughable compared with those fire fighters.
Maybe Mayor Bloomberg’s plan is to keep EMS too busy to realize what is going on. Don’t tell.
Followed by NY City Decides to Cut Back on Ambulances – Comment from John and later followed by Excellent Coverage of Mayor Bloomberg’s Attempt to Blackmail Voluntary Hospitals.