The Transfer of Power and the Implications for EMS

The Transfer of Power and the Implications for EMS

The Election is Over: Now What?

Election Day 2020 has come and gone. While the matter is not completely settled in all the races around the country, it seems that we know a few things about the balance of political power in Washington, DC.

• • Leadership in the Executive Branch will change
    The White House will change hands on January 20, 2021. After a hotly contested election and all the related fallout, there will be a new President in January. The new administration will take months to build up and get settled in.

• • Congress will Remain Divided
    The Republican Party will likely retain control of the Senate (pending the Georgia runoff results) and the Democrats will retain control of the House. The margins in each chamber will apparently become thinner; however, the balance of power will remain just that… balanced.

• • Action will Require Collaboration
    The balance of power in DC will ensure that no party or faction will have a mandate to pursue policy initiatives in a unilateral fashion. Any progress on policy will require collaboration and compromise. Building a coalition around addressing a particular challenge faced by our nation will be essential.

One nod to the possibility of collaboration is the longstanding relationship between President-elect Biden and Senate Majority Leader McConnell. The two men have collaborated to find middle ground, for the benefit of the country, several times in recent years. This will certainly be an area to watch.

Implications of Health Care Policy on EMS

Given the new era in Washington, DC, and some regional changes in state government, both executive and legislative branches, it is more important than ever that EMS leaders stay engaged in the political process. There are a multitude of issues that could impact EMS and the broader health care delivery system.

• • Activity and Call Volumes
    Given the negative COVID 19 trends and the rhetoric during the election cycle, it would seem reasonable to expect additional restrictions of activity around the country over the next few months. These restrictions, along with the response of the broader health care system to the crisis, equate to a likely decline in EMS call and transport volumes throughout the remainder of 2020 and into early 2021. Agencies should be planning operationally and financially to live with a new normal.

• • Additional COVID Pandemic Related Relief
    The most recent health and infectious disease reports indicate that the Coronavirus still has a grip on the world and the outlook here in the United States is concerning. While the severity of illness and the mortality rate are not as pronounced as they were in the spring for some areas, many areas are only now seeing the most severe case-loads. COVID 19 and its impact remains the top concern facing our leadership. Regardless of the promising vaccine news, some form of economic relief in the near term is essential. Getting meaningful relief from legislation will be challenging; however, there is a strong desire to proceed among both political parties. Ushering in a new era of cooperation with much-needed relief would be a fantastic way to reset the tone of the debate and allow both parties to respond appropriately.

• • Medicare Fee Schedule Adjustments
    While there has been a great deal of discussion regarding the need for Medicare payment relief for ambulance services, the prospect of any near-term relief in the area is limited. In addition to the shift in focus created by the pandemic, the COVID 19 has also delayed the Medicare Cost Reporting process by at least a year. The data from the reporting process could serve as a catalyst to have the Medicare ambulance payments adjusted. We will be waiting a while longer to get the first wave of results.

• • Obamacare and the Uninsured
    The prospects of a complete rollback of Obamacare and the anticipated spike in the uninsured ranks have been averted at this point. At the same time, the unemployment numbers, especially in the lower-income population are still at alarming levels. The unemployment rate and a rollback of Obamacare could have resulted in catastrophic payor mix changes for EMS.

Looking Ahead

As the EMS and medical transport industry looks forward to 2021 and beyond, there is still a great deal of economic uncertainty. It will be increasingly important for EMS leaders to engage in the political process and focus on the key aspects of their financial health. Leaders should understand and manage their costs, ensure compliance and performance in the revenue cycle management process, and build FLEXIBILITY into their approach.