How Best to Measure and Report EMS Costs: Toolkit Available

September 12, 2013

Source: NHTSA’s EMS Update

Have you ever been asked to justify the amount of your community's budget dedicated to EMS? Have you tried to determine the true cost to add a vehicle (direct costs, staffing, maintenance, insurance, etc.) or a new service (e.g., community paramedics)? A new economic toolkit could help you determine the true cost of delivering EMS to your community.

"This important resource allows EMS costs to be measured the same way as other healthcare costs," said Susan D. McHenry, EMS specialist for the Office of EMS, National Highway Traffic Safety Administration (NHTSA), Department of Transportation.

The EMS Cost Analysis Project came from a recommendation from the National Association of State EMS Officials (NASEMSO), and the toolkit was developed under the leadership of Brooke Lerner, Ph.D., of the Medical College of Wisconsin.

Lerner, working with Ronald Maio, DO, MS, of the University of Michigan, Herbert Garrison, MD, MPH, of the East Carolina University, Daniel Spaite, MD, of the University of Arizona, and Graham Nichol, MD, MPH, of the University of Washington, identified that a uniform method of determining EMS costs did not exist. To address this, they developed a uniform framework for calculating EMS costs.

This initial cost analysis framework was published in the Annals of Emergency Medicine in March 2007. After the framework was developed, the cost analysis process was captured in an easy-to-use workbook, which can be used by EMS agencies to determine specific and overall costs.

"The Toolkit allows you to not just explain costs, but also to review the incremental costs so you can look at outcomes and perform cost/benefit analyses," said McHenry. "Using this method, you can decide if adding a community paramedic program, for example, would reduce any of your other costs."

Three communities, representing urban, suburban, and rural EMS delivery areas, pilot tested the workbook: Richmond, Va, Oshkosh, Wis., and Livingston County, N.Y. According to McHenry, each of the communities who tested the toolkit said that it was really very useful.

"The Toolkit is designed so an agency can use it to look at just its own costs or the cost of delivering EMS to the whole community," she said. "The results can be viewed as total or incremental costs, and the community view is recommended since it provides a more realistic perspective."

Feedback from the pilot communities' experiences is incorporated into the final toolkit.

Download the free EMS Cost Analysis Workbook and Guide.