EMS 2024: Expert Forecasts for the Year Ahead

As we enter the new year, what can we expect to change in the EMS industry? To find out — or at least to get some informed predictions — EMS World spoke with Andrea Abbas and Daniel Gerard. Abbas is the EMS programs manager with the Michigan Center for Rural Health-State Office of Rural Health, a practicing paramedic and EMS consultant. Gerard is the president of the International Association of EMS Chiefs, as well as being EMS coordinator for the City of Alameda Fire Department.  

EMS World: What do you expect to be the biggest trends and challenges for EMS in 2024? 

Andrea Abbas: Moving into 2024, EMS organizations that prioritize practitioner wellness and operational boundaries will thrive and attract talent.  

National and local EMS leaders will continue to collaborate and advocate for improved reimbursement rates and funding to address the cost of readiness for ambulance services. EMS system response models such as tiered responses will continue to evolve as paramedic practitioners become scarce. Rural EMS systems will continue to face financial challenges due to low call volumes and significant costs related to readiness and workforce development. 

Community Paramedicine and Mobile Integrated Health will continue to evolve and grow within healthcare systems filling healthcare gaps through value-based care. Travel paramedicine is trending as EMS agencies look to mitigate workforce shortages. As an industry, we are addressing data poverty relative to a better understanding of staffing and workforce attrition. This year, EMS researchers will continue to be focused on workforce data to better understand practitioner attrition and shortages.  

Daniel Gerard: I think that one of the biggest challenges will be how we continue to finance and fund the system. This is of increasing concern, especially with the loss of so many personnel who do not either want to enter the field or who are leaving the field for better-paying jobs or moving into other sectors of healthcare or the public safety sector.  

Unfortunately, we can't address things in regard to pay benefits and better working conditions unless we're on solid ground. So I think that we're going to see a greater concentration in that regard.  

Now conversely --- the thing that goes hand in hand with this is if I'm a city administrator and you are my EMS department or you are a contracted service provider and we're going to go out to bid --- one of the things I think that not only the career and elected officials want to know, but the public wants to know is, where is the sugar for my dime? What do I get by paying more money for this service that we haven't had to pay in the past? And I think at this point we're going to see more municipalities shift toward outcomes and performance. 

EMS World: What efforts are being made now to help the EMS industry address these trends and challenges? 

Andrea Abbas: A greater effort is being made to address practitioner mental health and wellness. There are many emerging associations, educational platforms, and courses becoming available to better prepare organizations and practitioners to cultivate mental health and wellness best practices. My hope is that these positive efforts will evolve into a more holistic approach. 

National, state, and local associations continue to advocate for improved EMS payment models and reimbursement. 

Many state and federal bodies along with trade associations are actively supporting and funding initiatives focused on rural EMS. Sustaining rural EMS will continue to be a challenge in 2024 due to the current reimbursement paradigm and disparities in EMS system infrastructure. The independence of EMS as an industry is both a gift and a curse.  

Many national and state organizations have launched focused research project work to better understand workforce data. We will know much more about attrition, where paramedics and EMTs are working, and industry retention in the coming years through these studies.  

Payment reform focused on Community Paramedicine will continue as health systems begin to develop CP-MIH programs focusing on value-based care. My hope is a CP payment service line will be established.  

There are many scholarships and earn-to-learn programs for aspiring paramedics and EMTs emerging across the nation to alleviate staffing challenges.

Daniel Gerard: One of the surprising things is that we are seeing a grassroots effort across the country from the labor movement, galvanizing people across the United States in regards to active involvement in improving pay and benefits for EMT/paramedics, and also poking the bear, so to speak, in regards to how we finance and fund the system — because historically in the past when we have seen increases in the Medicare and Medicaid reimbursements, we don't see a corresponding increase in pay and benefits. 

And then the other side of the coin is that, when we look at community paramedic programs and crisis mobile response teams, what is the value that those services provide to the community? How do patients make out at the end of the day?  

Years ago when EMS first started, there weren't many benchmarks that people could quantify what was being done. It was just the fact that we have paramedics and we can provide that service. Now we pay greater attention to cardiac arrest and other patient-centered outcomes. 

EMS World: What ‘good news', if any, could arise for the EMS industry in 2024? 

Andrea Abbas: The field of EMS continues to be an industry fueled by purpose and passion. The work at any level offers the opportunity to help others, solve problems, and serve the community.  

2024 will be a year that offers data insights into the workforce shortages, scholarships for aspiring EMTs and paramedics in many areas of the country, tiered response systems with a decrease in the use of lights and sirens, and innovative healthcare delivery models designed to ease hospital and EMS system demand and misuse.  

The discussion around graduate-level paramedic practitioners is an indicator of the EMS profession's elevation and growth to come. The future is bright, and EMS is evolving as a profession.  

Daniel Gerard: The people entering EMS now are invested in seeing improvements in the system. And it actually makes me feel very good to see that they are.  

People are worried because some EMS workers seem kind of activist, but I don't see it in that manner. I see it as a great thing that they really want to improve their systems, they want to improve their work conditions, and they're actually invested in improvement overall. So that's one of the most encouraging things that I see.  

It goes without saying that new technologies that are coming down the road at some point in the future will make EMS better. Those advances are just going to grow by leaps and bounds every year. At a certain point, it'll be hard for us to keep up with it!