New business

[emtblifr]

I am the Asst. Chief of Operations at a private Ambulance service in upstate NY. The company i work has been around for almoast 50 years. It was started by my grandfather, and has been passed down through my family. I have been here 9 years, and due to some outstanding circumstances, it looks my time to take over the business will be sooner than expected.
We have basically done business the same way throughout our existance. I am looking to change things up a little bit. With government and insurance restrictions on allowed payments, im looking for an idea to maximize profits. I know some may look at this as selfish due to the nature of the business itself. However, to me, first and foremost it is a business. I have 40 or so wonderful employees, from billing specialists to EMT-B's and Paramedics to Dispatchers. We unfortunately do not have the profits to really give annual raises or bonuses at holidays. I feel awful because my group works hard, and like most EMS personell, deserve more.
I want to do something new and different that can give my company and edge, something that can raise profits. Im looking for helpful ideas. My email and yahoo name are listed on my profile. If anyone has any ideas, please hit me up.

 

[FDJohn]

I don't mean to be nosy, but everyone runs things differently. Maybe if you provided a little on your budgeting we could all pick at it and see what we could come up with.
I do know this much, not a single patient can walk...ever

 

[emtblifr]

well as far as what we bring in from insurances, we rarely dont get paid for pcr documentation. our billing people are very good at what they do too. our out going mostly is payroll, vehicle maintenance, supplies, and keeping the lights on.
unfortunately, as good as our billin people are, they cant control what insurance companies give us, and they cant control when things break down.
my train of thought now is, is there an idea where we can get income through private pays that we can control.

 

[MagicTyler]

If you do 911, I know several companies that do a yearly plan to offer free transports to patients if insurance doesn't pay. They charge a yearly subscription fee to allow people free transports. The number of people who pay for the service out weigh the cost of transports for the few who actually take advantage of the service that have no insurance.

 

[Jon]

The yearly plan / membership program is very common with small-town services around here.

As for "predicting when things break" - its called aggressive PM. There are many good examples of aggressive PM almost eliminating vehicle down-time.

As for appreciating your employees - look up Thom ****'s columns in JEMS. He has a wealth of ideas of "little things" that could make your place a true gem to work for.

 

[bahnrokt]

Where in Upstate NY are you? Do you do 911 or IFTs or both? What type of business background do you have?

With insurance companies our $ per ride is more or less fixed. So to maximize profit you either have to find better ways to transport for less and/or find ways to have less downtime on your rigs so that they are always earning. The only real win-win I know
of is event coverage. Your paid by the event organizer to staff the event and get to bill any transports insurance. But unless you have several large venues in your CON it is tough to drum up this type of business.

I would be attending your regional and county EMS meetings in your CON. Follow local politics. As vollies like me drop off I would be looking for a weak agency that is having response trouble that I can cover from my current base of operations. You may get lucky and catch the ear of a newly elected supervisor and find a way to save him money.

As a tip to a new boss, a lot of employees understand that times are tough and companies cant throw raises around willy nilly. But see if you cant find smaller ways to show you value you staff. My old company used to give everyone a ham at Christmas and later changed it to a $50 gift card to the local super market. My current company has a points program that rewards employees for performance. As you collect points you can spend them on company swag.

 

[RocketMedic]

If you've got a county or city 911 contract, you can start working on putting yourself on more of a public utility model- perhaps a $5/month optional charge on a water bill? Reach out to local politicians and the media, let them know what services you provide, and paint a realistic negative picture of what funding cuts will mean for y'all.

Invest in some PR too, take a reporter on a third ride with one of your good emergency crews and let them see what y'all do.

 

[AlphaButch]

There are often alot of things that seem small but add up to eat up on budgets, I'd look at reducing/controlling overhead first as it will get faster results. Some ideas off the top of my head given little specific information are;

Join a purchasing group for your medical supplies/equipment - this can often get you an extra 5% savings.

Reduce office waste - go electronic if possible. Review your processes.

Reduce fuel waste - more reviewing of processes (this could mean condensing shifts, are your crews posting places or running still alot?, good PM on the trucks, etc)

Look at how much you are spending on "emergency" repairs, as these are normally more expensive than an aggressive preventive maintenance program (this was already suggested).

Income through private pays can be increased through utilizing a collection agency / person. You would have to look at your numbers for this one. Are you needing to increase your gross unadjusted income here? or raise your actual collection percentage?

More long term - Look to your sales/marketing team. How much time is spent on dead leads? You may be surprised how much time is wasted on marketing towards business/segments that you don't want or that would have too low a margin to be profitable, make sure that your sales/marketing folks have qualifiers.

There's probably alot more possibilities but they would be agency specific. I suggest reviewing your current processes, then perhaps contacting a consulting firm (can be cheaper than reinventing the wheel).

 

[DrParasite]

where in upstate NY are you?

as AlphaButch said, try to control the expenses you can control. limit office waste. minimize OT by staffing appropriately. maximize productivity. bulk order supplies, especially those that don't expire. only accept transports that are profitable.

Aggressive PM is another one that was suggested. it's much easier to maintain trucks than to put it off and have to pay for expensive repairs.

 

[FDJohn]

You could take on some volunteers. Also with PM, I used to work on the ambulances (ratchet and socket not IV and fluids). There's some stuff that you can do yourself in house that will save you a ton of money. Every time a scheduled oil change is due it is imperative you check the following things: Tire pressure, air filter, the drive belt, and change the fuel filter every year. All of that stuff can be done in house much cheaper than it can be taken to a shop for. The guy that services our big red truck does so for free in the engine bay. All he asks for is a tax write off.
Don't discount the effect that having volunteers has. It eases the workload for your paid guys, looks good at tax time, and it gets young guys their wings.:lol:

 

[emtblifr]

Thanks for all the ideas and thoughts folks. Extremely helpful!! THANK YOU THANK YOU!!!!