Nice to see the progressive leaders of an outstanding EMS agency implementing scientific, evidence-based system design changes to enhance patient care, improve employee morale, and reduce system costs!
An overview of the assessment that led to these changes, and how the KCEAA Team is implementing these them will be presented at the upcoming American Ambulance Association Conference and Trade Show in Lexington, KY June 22 - 24, 2025.
Response Reboot? Implementing Data Driven Decisions for System Sustainability – A Case Study
https://annual.ambulance.org/session/response-reboot/
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KCEAA implementing changes to cut costs while improving service
by: Blake DeJarnatt
May 5, 2025
https://www.wowktv.com/news/west-virginia/kanawha-county-wv/kceaa-implementing-changes-to-cut-costs-while-improving-service/
CHARLESTON, WV (WOWK)- Leaders with the Kanawha County Emergency Ambulance Authority met Monday to discuss how they can tackle a $4 million deficit, while improving the quality of their medical care.
The way it works now is whichever ambulance is closest to an emergency call is dispatched, even if they aren’t best suited for the job. In partnership with Metro 911, they plan to implement “tiered responses,” a system that would ensure the best ambulance available for the situation would be dispatched, regardless of proximity to the emergency.
“Tiered response is basically taking the appropriate ambulance and dispatching it to the appropriate situation. So, if you have a cardiac situation, you need one level of staffing as opposed to, say, you have a sprained ankle, that kind of simplifies it. Taking advances in technology and making sure the appropriate ambulance, the appropriate equipment is being dispatched to the appropriate situation,” said Tom Susman, a spokesperson for KCEAA.
This system would ensure that Advanced Life Support (ALS) vehicles would be dispatched to dire emergency situations, like a heart attack or stroke. Basic Life Support (BLS) vehicles would be reserved for what would be considered minor injuries, like a sprained ankle or broken finger.
Susman says that this initiative could save costs when it comes to how to best utilize resources and cut back on overtime pay for paramedics. When a BLS squad is sent to a critical situation, they may take more time at the scene than an ALS squad would.
“I think you’d be able to save KCEAA money because you’d be able to do away with some duplication. It would be a more efficient use of resources. It’s also good for paramedics. The staff want to be able to dispatch to their level of training. So, for example, you don’t have a primary care doctor going to the cardiac unit, and conversely, you won’t have a cardiac doctor going to a primary care situation,” said Susman.
Susman says the KCEAA is also putting feelers out in having a third-party organization take over their billing operations. He says that they’re still waiting on the board of directors’ approval, but that having a third party take over could lead to a more streamlined and cost-effective billing process.
“Billing in medical services is becoming more and more complicated,” said Susman. “You need to keep your equipment up, ’cause insurance companies are tough to bill with. So, if you have somebody who does this for hundreds of thousands of people across the country, or millions of people, they have better systems than a stand-alone EMS agency might have. So, it’s really, it’s just trying to find out if there’s a way to do it that generates more resources and better use of the dollars.”
Susman says that some of the main reasons for the $4 million deficit are increased operating costs, offering competitive pay for their paramedics, and low reimbursement rates from insurance companies.
Susman says that they plan on implementing tiered responses in the next 90 days, but they won’t launch the new system until they are certain it will work the way they have planned.
