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Rural Emergency Medical Services (EMS) and Trauma – Resources

Selected recent or important resources focusing on Rural Emergency Medical Services (EMS) and Trauma.

Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Before and During Covid
Results of a study describing changes from 2018-2022 in emergency department use among rural and urban Medicare Fee-for-Service (FFS) beneficiaries. Features statistics including patient demographics, primary diagnoses, and admission sources, with breakdowns by urban and rural areas.
Author(s): Alana Knudson, Craig D. Holden, Marilyn Klug, Tricia Stauffer, Shena Popat
Date: 01/2025
Type: Document
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Emergency Triage, Treat, and Transport (ET3) Model: Final Evaluation Report
Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Ground Ambulance Data Collection System (GADCS) Report: Year 1 and Year 2 Cohort Analysis
Provides data from the first two cohorts of ground ambulance organizations selected to participate in the Ground Ambulance Data Collection System. Includes response rates, information on data cleaning and validation, statistics summarizing responses, and analyses exploring relationships between costs per service and organizational characteristics. Features statistics with breakdowns by urban, rural, and super rural areas.
Author(s): Andrew W. Mulcahy, Sara E. Heins, Petra W. Rasmussen, et al.
Date: 12/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Emergency Medical Services (EMS): A Look at Disparities in Funding and Outcomes
Details disparities related to rurality, income, sex, and race in emergency medical services (EMS) funding, staffing, and patient outcomes. Provides a case study of local EMS agencies in 11 California counties, highlighting challenges rural agencies face related to funding and quality of care.
Date: 10/2024
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Medicare Payment Basics: Ambulance Services Payment System
Provides an overview of Medicare payments for ambulance services. Discusses rural add-on payment policies, geographic categories determining payment rates, super-rural ZIP codes, and ambulance fee schedules.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Workforce Toolkit to Support Critical Access Hospitals and Rural Providers
Toolkit intended to help Critical Access Hospitals (CAHs) and other rural providers improve workforce recruitment and retention efforts. Provides information on healthcare workforce challenges faced by CAHs. Offers examples of external resources that CAHs may utilize to address their workforce needs across four topics: organizational culture and leadership, leveraging partnerships, emergency medical services workforce, and administrative and support staff workforce.
Date: 09/2024
Type: Website
Sponsoring organization: Flex Monitoring Team
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With New EMS Quality Measures, Florida Aims to Have a National Impact on Rural Care
Features the Feasible, Actionable, Impactful and Relevant (FAIR) EMS Measurement Project, an initiative by the Florida Department of Health which developed rural-relevant EMS quality measures for use in the state and nationally.
Author(s): Gretel Kauffman
Citation: Rural Monitor
Date: 05/2024
Type: Document
Sponsoring organization: Rural Health Information Hub
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Ground Ambulance Industry Trends, 2017–2022: An Analysis of Ground Ambulance Organization Entrance and Exit
Describes ground ambulance trends from 2017 to 2022, focusing on organizational characteristics associated with organizations' entry into or exit from the Medicare program. Presents data on the likelihood of entry and exit by a ground ambulance transportation organization by ownership status; urban, rural, or super rural location; and volume. Examines the change in traditional fee-for-service Medicare ground ambulance transport volume at the county level after an organization enters or exits the market.
Author(s): Jonathan Cantor, Sara Heins, Petra W. Rasmussen, Christine Buttorff, Andrew W. Mulcahy
Date: 04/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Medicare Ground Ambulance Data Collection System (GADCS): Rural and Super Rural Organizations Tip Sheet
Covers 6 Ground Ambulance Data Collection System (GADCS) tips and common reporting scenarios for ground ambulance organizations serving rural and super rural areas. Intended to help highlight geographic differences in costs, revenues, and services.
Date: 02/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Keeping Rural EMS Reliable and Sustainable, with James Small
An episode of the Exploring Rural Health podcast featuring James Small, Rural EMS Outreach Director for the Wisconsin Office of Rural Health. Focuses on rural emergency medical services workforce and funding shortages, and how rural EMS can be maintained and expanded.
Date: 12/2023
Type: Audio
Sponsoring organization: Rural Health Information Hub
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Last Updated: 1/21/2025