EMS One-Stop emsonestop

In this special, on-site episode of EMS One-Stop, host Rob Lawrence takes us to the 2024 North Carolina EMS Expo in Greensboro, North Carolina, a well-attended conference with over 1,200 attendees.
Rob spent time with several conference faculty.

EMS lawyer Matt Streger joins Rob to discuss just culture, HR issue spotting, leadership communication and employee engagement.


Kevin Collopy joins Rob to discuss the outstanding prehospital training being delivered to medics in Ukraine and also discusses this years “Stand and Deliver” new speaker event (a now annual event held as EMS World Expo).


Rob discusses whole blood and its national rollout with Dr. Randall Schaeffer and David Grovdahl.


To close, Peter Dworsky of the National EMS Safety Conference provides an overview of the current top EMS industry safety themes.

Enjoying the show? Email editor@ems1.com to send in guest suggestions, episode feedback or questions for our host. 

Editor’s note: This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
In this episode of the EMS One-Stop podcast, host Rob Lawrence welcomes back Matt Zavadsky to discuss the latest development in the move to fund treatment in place and the recent disclosure from CMS about the potential savings to Medicare identified in the analysis of the limited ET3 program.
Matt discusses the potential legislative moves regarding EMS funding, highlighting bipartisan support and urging listeners to engage with elected officials to support bills benefiting EMS.
The conversation underscores the need for sustained advocacy efforts and highlights the level of interest shown by key policymakers.
Rob and Matt also discuss the recent developments in the City of Fort Worth and the decision to absorb MedStar into the Fort Worth Fire Department, emphasizing the need to ensure equitable treatment for EMS personnel transitioning to new roles.
Top quotes from this episode
“We can officially say that the net savings to Medicare after they pay EMS and after they pay the tertiary provider telemedicine, whatever it is, is still $550 to $570 per enrolled ET3 participant. And when you do the math, that's a billion dollars or more of savings to the Medicare program, which now CBO can use to evaluate the benefit, economically of doing a treat, no transport, treatment-in-place model. So it's big news.” — Matt Zavadsky
“Nobody benefits from a knock-down, drag-out fight. But as you indicated, there are now people in the community and people across the country that are saying why and what does this mean? We don't have all those answers, but again, it's the decision from the folks who are elected to represent the community and if that's what they want to do, that's great. Our role is to try and do as much as we can to maintain a transition into a new provider system that keeps those core tenants – the high performance, high value mobile, integrated healthcare, flexible deployment. All those things that have really made the system a world class EMS system, even though it might say something different on the side of the ambulance and the employees might be wearing a different uniform.” — Matt Zavadsky
“It's going to be a long transition – 12 to 18 months, and it's not just branding and rebranding, it's really infusing the culture of a group of people who are used to doing 7-10 calls in 12 hours and used to having things operate with a certain cadence that's going to be totally different when they start a different type of organization.” — Matt Zavadsky
Episode contents
00:00 – Introduction
02:15 – ET3/TIP: Challenging CMS outcome data
03:15 – Cost savings per intervention
04:00 – CMS data showing net savings to Medicare
04:30 – Congressional Budget Office score based on savings
06:00 – Net savings of a billion dollars or more
07:00 – Applying this new information for the good and benefit of the industry
09:00 – Congress is, is what Congress does
10:40 – Meeting with Congress to push TIP
14:30 – Fort Worth and the PWW Advisory Group
14:50 – Fort Worth economies and level of service
17:30 – Matt Zavadsky to join the PWW Advisory Group
19:15 – The staffing issues as Med star staff transit to the FD fire department
21:00 – Ensuring the staff is protected
25:00 – Call to action-how we communicate all value to elected officials
26:00 – Final Thoughts
About our guest
Matt Zavadsky is the former chief transformation Officer at MedStar Mobile Healthcare, formerly the exclusive emergency and non-emergency public utility model EMS system for Fort Worth and 14 other cities in North Texas.
Coming to MedStar in 2008 as the operations director, Matt made significant changes to the EMS delivery model, and in 2010, successfully eliminated the need for the t

In this episode of the EMS One-Stop podcast, Dr. Edward Racht and Matt Zavadsky join Rob Lawrence to discuss their recent attendance at the U.S. House Committee on Ways & Means hearing on “Access to Health Care in America: Ensuring Resilient Emergency Medical Care,” which took place in an off-site hearing in Denton, Texas, on March 18, 2024.
Dr. Racht, chief medical officer of Global Medical Response; and Zavadsky, chief transformation officer for the Metropolitan Area EMS Authority (MedStar Mobile Healthcare) discuss the evidence and the key issues they conveyed to the committee.
Dr. Racht's testimony included:

The significant advancements made in emergency medicine over the past decades, leading to reduced mortality and disability rates for patients.


The importance of updating Medicare reimbursement rates for ambulance services, which have not been revised for over 20 years.


Advocating for wholesale reform of Medicare's coverage of emergency medical services to align with contemporary practices, such as covering treatment in place and transportation to alternative healthcare sites.

Matt Zavadsky's testimony included:

The impact of CMS payment policies on EMS, which incentivize unnecessary transportation of patients to the emergency room.


Innovative programs initiated by EMS agencies to prevent unnecessary 911 calls and navigate patients to appropriate care settings.


Legislative changes required to provide EMS with flexibility in patient navigation, including treatment in place and transport to alternate destinations.


The challenges faced by ambulance services nationwide, especially in rural areas, exacerbated by the COVID-19 pandemic.

Top quotes from this episode
“We are the front of the frontline in medicine.” — Dr. Ed Racht
"Our coordinated and integrated EMS and healthcare system now gives gravely injured patients ... the opportunity for rapid surgical intervention and a chance at full recovery." — Dr. Ed Racht
"Emergency healthcare professionals pride ourselves on our ability to dramatically decrease morbidity and mortality from unexpected and sudden illness and injury." — Dr. Ed Racht
"CMS payment policy is such that we are incentivized to transport every 911 patient to the ER because that is the only time we get paid." — Matt Zavadsky
"Ambulance services are a vital component of our local and national healthcare and emergency response systems." — Matt Zavadsky
"Innovative EMS agencies ... have initiated patient-centric programs designed to prevent 911 calls and navigate patients to the most appropriate care setting." — Matt Zavadsky
"Ambulance services across the nation, especially in rural areas, are facing unprecedented challenges." — Matt Zavadsky
Episode contents
0:05 – Introduction
0:55 – Guest introduction
1:40 – Explaining the Ways and Means Committee
2:30 – We are being noticed!
3:40 – Preparing for a congressional hearing
5:40 – The impact of having a congressional hearing in an EMS location
5:58 – The genuine interest of the committee members
9:00 – Dr. Ed Racht testimony to the Congressional Ways and Means Committee
14:24 – Matt Zavadsky testimony to the Congressional Ways and Means Committee
20:52 – Dr. Racht and Zavadsky’s reactions to the evidence they gave and the feedback
29:00 – Zavadsky’s key points he wished to reinforce during his evidence session
31:45 – Balanced billing, patient protections and removing the patient from the middle of the process
32:50 – Independent Dispute Resolution (IDR) and its challenges.
38:29 – Questions for Secretary Becerra on Capitol Hill
44:00 – Final thoughts
45:00 – A call to action to become one and present a united front “When we unify, we are unstoppable.”
48:00 – You the listener are the great politician

Editor’s note: This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
“Honorable but Broken: EMS in Crisis” is a documentary film exploring the world of EMTs and paramedics, the collapse of the EMS system, and what needs to be done to save it. Narrated by six-time Golden Globe and two-time Primetime Emmy award winning actress, Sarah Jessica Parker, “Honorable but Broken” raises awareness of the systemic collapse of EMS and advocates for change.
In this episode of the EMS One-Stop podcast, host Rob Lawrence chats with producer Bryony Gilbey about the documentary that is now completed and available for streaming. Gilbey hopes the impactful, hard-hitting documentary will serve as a briefing and education tool for our elected officials and members of the general public.
As Gilbey notes, “It’s no good any longer just throwing up your hands and saying that’s just the way EMS is; it’s no good saying it’s someone else’s problem; it’s something we all need to work on, as a civilized society we need to address this issue and we need to do it quickly.”
The 60-minute documentary is now available on demand, streamed by Prodigy EMS and it is hoped that it will be used at local, state and national levels to bring attention to the issues we are facing.
Top quotes from this episode
“I expected to tell a story; I did not think that it would have quite this reaction” — Bryony Gilbey
“We now all have not many degrees of separation to somebody who has had some sort of PTSD, who has had to leave the job because of the pressures of work and dare I say ultimately taken their lives and that is incredibly sad.” — Rob Lawrence
“It all comes down to three words – all in favor – if we don’t get the vote, we don’t get the money, we don’t get the change.” — Rob Lawrence
Episode contents
00:48 – Documentary teaser
01:18 – Introduction/Bryony Gilbey
02:16 – The “Honorable but Broken” back story
05:46 – How did Gilbey view EMS and its issues
08:15 – The finished product and how can we view it
10:24 – A federal screening on Capitol Hill
11:30 – Reaction from elected officials
13:16 – John Mondello/emotional trauma
14:00 – Eileen Mondello – John’s mother
15:25 – Reaction to Eileen Mondello – “It never gets easier’
17:00 – He wasn’t the first, he isn’t the only and sadly he won’t be the last
22:00 – Other featured speakers in the documentary and their powerful messages
22:30 – Recruitment, retention and retirement
24:35 – What is the cost of a human life to a politician?
26:25 – Educating the legislators and the public
28:00 – The cost of readiness
29:05 – Reimbursement doesn’t add up
31:00 – The hospital side of things – Beckers Review on Hospital closures and adding to ambulance and hospital deserts
31:30 – Call to action and the legislative agenda
35:30 – Sarah Jessica Parker
39:00 – How and where to view via Prodigy EMS
39:50 – Final thoughts
About our guest
With a prolific career spanning several decades, Bryony Gilbey is a seasoned director, producer and freelance writer/editor, distinguished for crafting compelling narratives across various media platforms. As the director/producer for the impactful EMS documentary, “Honorable but Broken: EMS in Crisis,” Gilbey has showcased an unparalleled ability to guide projects from inception to completion.
Gilbey previously worked with the Nexstar Media Group, Inc. as a freelance writer/editor. Here, she demonstrated versatility by producing feature pieces on health and lifestyle topics for Tribune Publishing and contributing to BestReviews.com.
Gilbey also served as an associate producer at Mary Murphy & Co. from 2005 to 2012. During this period, she played a pivotal role in the production of the PBS American Masters

Collecting and communicating the big EMS news of 2023
The American Ambulance Association and the Academy of Mobile Healthcare Integration (AIMHI) collect, collate, categorize and share weekly EMS-based news stories widely with many national organizations and associations, including NHTSA, USFA and NAEMT.
The information contained in the news tracker allows officials and EMS leaders to brief and educate journalists and elected officials, as well as the public as to the current plight of EMS. EMS is delivered on a local level and those experiencing issues with their service can believe it is just them suffering funding shortages, staffing challenges, hospital delays or general poor performance. The tracker can be used to demonstrate that the issues are occurring on a wider regional, state, national and, in some cases, international level.
In this episode of the EMS One-Stop podcast, host Rob Lawrence, who also heads up the AAA-AIMHI news collation effort, welcomes fellow news collator, Rodney Dyche of Patient Care EMS; and AIMHI Education Committee Chair, Matt Zavadsky, chief transformation officer at MedStar Mobile Healthcare. Rob, Rodney and Matt examine EMS news and current trends, and discuss how these themes can be used to inform, influence and educate.
Top quotes from this episode
“There's a perverse ‘incentive’ about response time … if you have the target of 8:59, you arrive on time and the patient dies; that's a success. If you arrive in 9:01 and the patient lives; that's a failure. That's absolute garbage” — Rob Lawrence
“There was a quote from Dr. Clawson in a news story that was done in Minneapolis, and I love his quote. He says, ‘there is no evidence that using red lights and sirens have saved more lives than they've taken.’” — Matt Zavadsky
“Every week in this great country, an ambulance is stolen either from hospital or from scene – that's avoidable.” — Rob Lawrence
“Stop being timid. Stop licking your wounds. Get out in your community, talk to your elected officials. Talk to your city managers or county administrators – very factually, not emotionally. There will be time for emotions, but give them the facts and let them know what it's gonna take to resuscitate their EMS delivery system.” — Matt Zavadsky
Episode contents
00:23 – Guest introduction
02:06 – AAA/AIMHI News Tracker and story categories
04:22 – A resource to brief the press and elected officials
04:30 – Operational challenges across many states
05:50 – Massive sign-on bonuses – robbing Peter to pay Paul
06:30 – Staffing and funding issues
08:40 – Communities/local governing bodies facing the fact that they are running out of money, and their EMS isn’t free
09:40 – Transitioning from a volunteer to a paid system
11:00 – Explaining EMS economics to your elected officials
11:50 – Has anyone died? Bring data
13:30 – EMS systems closing
15:30 – “Elected officials get nervous deciding to allocate funding to a service that they haven't had to fund or haven't, haven't had to fund to this certain level in the past.”
18:40 – Response time
19:25 – Increase in low acuity calls
20:30 – Service design
22:50 – Single- versus double-paramedic crewed trucks
25:04 – MEDIC Charlotte – Taking bold steps within categories of response
27:00 – The rate of ambulance crashes across the county at intersections
27:47 – If you are not the ambulance driver … who is?
29:49 – There is no evidence that using red lights and siren have saved more lives than they've taken!
30:30 – Stolen ambulances
32:59 – Supply chain and vehicle availability
34:00 – Rurality and ambulance deserts
35:00 – Violence against providers
37:00 – Responding to patients in crisis/agitated patients
38:00 – How to use the media log in your locality to good effect
40:00 – Final thoughts
About our guests
Matt Zavadsky is the chief transformation officer at MedStar Mobile Healthcare, the exclusive emergency an

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
The American Ambulance Association recently held its annual AAA Stars of Life event in Washington, D.C. The American Ambulance Association’s Stars of Life program celebrates the contributions of ambulance professionals who have gone above and beyond the call of duty in service to their communities or the EMS profession.
While in Washington, EMS One-Stop Host Rob Lawrence interviewed AAA President Randy Strozyk, on the aims and objectives of the stars program and the 2023 Legislator of the Year. Rob also spoke with AAA Medical Director Dr. Gerad Troutman, who is AAA’s first medical director. Finally, Rob chats with AAA Immediate Past President, Shawn Baird, on the Federal Balanced Billing legislation and the role that AAA and others are playing in protecting both the patient and EMS agencies.
Top quotes from this episode
“Every provider is out to make a difference, but to actually be recognized for it, which you don’t often get the opportunity to have, makes it that much more of an honor to be selected for something like this” — Paramedic Erica Brockman
“AAA stars and hundreds of thousands of people like you are the beginning of the healing process. When somebody is hurt, somebody is wounded, somebody is scared, it is the EMT that first touches that patient and then begins to transport into the healthcare system when the rest of the healthcare system can then kick in to what it does, but it would not start unless it begins with you.” — Senator Bill Cassidy
“Think about when Covid hit, at 0200 in the morning, we were the ones that came, we were the ones that had to deal with a whole new level of challenges, not only Covid, but we had to deal with the fact that people didn’t want to go to the hospital, so we were providing levels of care, interfacing, making sure that people had connections. I see that as a bright future to how EMS will progress in the next decade” — AAA President Rany Strozyk
“I’m really passionate about patients called 911 looking for solutions to a problem and that solution is not always an ambulance to take them to an emergency department, so we try to impact their care differently, especially lower acuity patients, because we now have all the technology and tools to treat them in place with our paramedics or EMTs on site of even treating them utilizing a navigation program from the 911 system, the PSAP and maybe get them to an urgent care or virtual care doctor, where they can be cared for right in their home. Patients love it and the best thing is it really puts the ‘E’ back in EMS and allows us to save those emergent resources that need those most.” — Dr. Gerad Troutman, AAA medical director
“We will be coming back to Congress with a recommendation that ground ambulance not be rolled into the No Surprises Act. That (if we were included) would be devastating to access for care.” — Shawn Baird, immediate past president, AAA
Episode contents
00:21 – Opening: Erica Brockman
01:02 – Introduction: Rob Lawrence
01:36 – Randy Strozyk, president, American Ambulance Association
05:12 – Key areas of legislation for 2023/24
08:07 – Presentation of Legislator of the Year: Senator Bill Cassidy
11:00 – Dr. Gerad Troutman, AAA medical director
17:00 – Federal Balanced Billing Committee: Shawn Baird
18:35 – Summary and close
Additional resources
 The full bios for all of the AAA Class of 2023 Stars of Life can be found here.
Listen to next: Alexia Jobson, Dr. Peter Antevy, Brian Maloney, Doug Wolfberg and more join the EMS One-Stop podcast to discuss takeaways from the show
About our guests
Randy Strozyk brings to his leadership of the American Ambulance Association more than 34 years of experience in EMS operations and management. He