Developing an Exceptional Ambulance Marketing Program

You’ve got the best ambulance company in the market. You have invested in great equipment, hired competent EMS staff and ordered some pens and notepads. You’re ready to grow, but how do you communicate this to your customers?

The simple answer is to hire a Marketing Associate to go out every day and drum up business. The problem is that there is usually very little time and possibly even less money for training.

Most ambulance companies hire one of their Emergency Medical Technicians or Paramedics to instantly become the “marketing rep” for the company. As you can imagine, this can be a challenge.

The skill set that makes for a great EMS professional is not necessarily the same set of skills that make a great sales person. Are you setting your company and your new Marketing Associate up for failure?

The key to success is to have a formal sales training program. You wouldn’t think of sending an EMT or Paramedic to a 911 call without a comprehensive in-house orientation and clinical training program. Why would you promote an EMT, hand them some pens and send them out to grow your company?

Marketing is a People Business

The first rule of the hiring process is to make sure your Marketing Associate is strong when it comes to the basics. Good communications skills and a genuine interest in meeting people are the golden keys to success.

It sounds simple, but many folks are great in a small personal setting, but freeze up when meeting new people. You can train a person to sell, but it is almost impossible to train a person to be a “people person.”

Selling is about attitude. Is your new Marketing Associate friendly, utterly reliable, and eager to learn?

Sales Training 101

If your company doesn’t have its own in-house training department and you cannot bring in an outside sales consultant, you’ll need to look closely at your staff to develop a sales training program that fits your company’s needs.

You’ll want to identify which of your management team not only has the strongest grasp of what the business goals of company are, but also has the most enthusiasm and interest in your services.

In addition to providing a detailed overview of the services your company offers, the following sales topics should be covered:

·      Mission Statement and goal setting for the next 24 months

·      Organization and time management skills

·      Selling your Ambulance Service line

·      Focus and follow -up with customers

·      Creating the sales pipeline

·      Prospecting and lead generation

·      Dealing with fear in sales

·      Developing presentations that focus on company strengths

·      How to close the deal

·      How to add value during the sales process

·      Relationship building and networking

·      Negotiations 101

As homework, make sure they read at least one good book on sales, for example, the One Minute Salesperson. Discuss with them what they are learning from the book as they read it.

Putting it all Together

After the initial sales training program, you’ll want to test the associate’s grasp of both the technical and sales skills they’ve learned.

Ask them to teach you about the company and evaluate how well they explain the services, their overall level of persuasiveness, friendliness and approachability.

You’ll be looking for an associate that can model the kind of sales behavior that develops relationships, creates a sales pipeline and persuades a decision maker to contract with your company.

Give Refresher Training

Even your best Marketing Associate will move away from the basics the longer they stay in the business.

It’s not at all uncommon to see associates succeed in their first year of business, only to watch them fall into a slump when they get away from the basics.

Much like refresher training for your EMS personnel, make sure there is formal refresher training for the Marketing Associate. Your marketing associate will only be as good or bad as you train them to be.

If you have poor producers, the fault may be in the lack of ongoing training. If it is, correct it. At a minimum, make your marketing associates role-play certain selling situations to strengthen them in the basics.

Final Thoughts

I believe that a marketing associate can know virtually nothing about the ambulance industry, yet still succeed, as long as he or she knows how to sell.

By the same token, I believe that a marketing associate, who knows everything about the industry, but nothing about sales, will eventually starve.

If you start with a simple sales training program and use the previous principles we discussed, I believe you’ll find that your salespeople will function to their maximum efficiency and effectiveness.

About the Author

Michael Shabkie has extensive ambulance business development experience with both the public and private sector. He has also served as a key collaborator for EMS system design, developed winning contracting strategies, managed sales and marketing departments, and acted as an executive advisor on operational processes for both public and private ambulance organizations.

For more information on scheduling the one day marketing boot camp for your ambulance or NEMT sales associates please visit:

Michael Shabkie

Successfully marketing an ambulance company and its’ services is a highly complex undertaking. The sales cycle can be prolonged, the competition fierce and current customers can be fickle. As ambulance company owners or managers, we have to understand our sales process intimately and have a “high touch” marketing plan that is finely tuned for the customer.
High Touch vs. Low Touch Marketing
Let’s compare high touch vs. low touch marketing to see where your ambulance company fits in. For example, how do you shop for a new car? If you are like most consumers, you start searching for various brands and explore car options, visit various car dealerships, take a test drive and after a relatively long research process you finally decide on the car you want to purchase. During this sales process, the dealership has a sales team on hand to actively assist you and can spend hours in…

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West Valley Health Care Leaders Unite In Effort to Save Lives Free Classes Offered For The Public On “New CPR”

The Glendale Fire Department, Midwestern University (MWU), and Priority One Enterprises have teamed up to launch a community education program to train citizens on a new and easier way to do CPR, called Continuous Chest Compression (CCC-CPR), along with the use of Automated External Defibrillators (AEDs). These two elements are vital to survival during adult Sudden Cardiac Arrest (SCA), which is the number one cause of death in the U.S.
“Calling 911 and starting immediate, rapid, forceful chest compressions dramatically improves survival,” said Ben Bobrow, M.D., Medical Director for the Bureau of Emergency Medical Services. “With CCC-CPR, there is also a greater chance of bystander participation.”
Continuous Chest Compression (CCC), the new CPR for adult Cardiac Arrests, was developed through extensive research at the University of Arizona Sarver Heart Center, and has been championed locally by Dr. Bobrow and showcased nationally on the NBC Today Show with Matt Lauer. CCC-CPR separates itself from traditional CPR by concentrating solely on chest compressions, not breaths, causing the continual circulation of blood through a victim’s brain and heart.
Glendale Fire Chief Mark Burdick, who worked for years as a fire paramedic, said, “I am excited about the statistics which show improvements made in patient care outcomes due to the implementation of the continuous chest compressions program. Our paramedics now have an added advantage to saving lives in Glendale, with the ultimate goal to train as many citizens as possible in CCC-CPR.”
“A major part of our university mission is community service,” says Ross Kosinski, Ph.D., Dean of Students and Director of Community Outreach for Midwestern University. “Having our team of health care professionals work with the City and Priority One on this new life-saving technique really meets that mission.”
In addition to the CCC-CPR training, this program is geared to take the “fear” out of AEDs, as most people are uncomfortable utilizing these life-saving devices when a situation arises. “We want to get the message out that they are easy to use, safe, and should become the safety standard in businesses throughout Arizona,” said Mike Shabkie, Managing Partner, Priority One Enterprises.
MWU and Glendale firefighters will team up to teach FREE classes to the community at Midwestern University (19555 North 59th Avenue) and the Glendale Regional Public Safety Training Center (11550 West Glendale Avenue) on the third Thursday of every month beginning November 15th at MWU at 7:00 PM. For more information or a schedule of classes and locations call 623/572-3329 or click here for a flyer (pdf).
Press contacts:
Karen Mattox, Midwestern University, 623/572-3310 or
Daniel Valenzuela, Glendale Fire, 623/930-3409 or
Mike Shabkie, Priority One Enterprises,

Midwestern University is a graduate degree-granting institution specializing in the health sciences with six colleges: the Arizona College of Osteopathic Medicine, the College of Health Sciences, the College of Pharmacy-Glendale, the College of Dental Medicine, the Chicago College of Osteopathic Medicine, and the Chicago College of Pharmacy. The Illinois campus, located on a 105-acre site in Downers Grove, is home to more than 1,800 full-time students. The Arizona campus, located on a 144-acre site in Glendale, is home to 1,536 full-time students. The University is accredited by The Higher Learning Commission, a Commission of the North Central Association of Colleges and Schools.



Dependable Medical Transport Services Bringing Heart Safe Environment and Driver Certification Process to Their Customers

(PRLEAP.COM) Dependable Medical Transport Services (DMTS), a leading non emergent transportation company, based in Phoenix, Arizona, announced today that it’s focus on safe, efficient transportation and extraordinary customer care will be further enhanced by placing Automatic External Defibrillators (AED’s) in each Paratransit van along with the implementation of a Certified Transport Specialist Program.

DMTS has partnered with Cardiac Science and Life Saving Solutions to provide Powerheart(R) AED’s, and a complete AED Program management solution.

Furthermore, DMTS’s industry leading driver certification program will ensure that all vehicle operators become Certified Transport Specialists (CTS).

DMTS Certified Transport Specialists complete instruction on a variety of safety elements including, but not limited to, First Aid, Automatic External Defibrillator (AED), Continuous Chest Compressions (CCC) training as well as Customer Service and Advanced Driver Education.

“We are committed to customer safety and satisfaction, and believe our investment in certifying our employees will establish us as an industry leader,” said Terry Reilly, Vice President of DMTS. “Our Certified Transport Specialists (CTS), are trained to activate the emergency response system (911), and have access to an easy-to-use AED. The comprehensive training our employees receive will not only positively affect our clients, but will affect their families and facilities they reside in. We strongly encourage other non emergent transportation providers to follow our lead”.

“Since we have been using DMTS for transport services, we have found that they are striving for excellence in a very competitive market”, said Lisa Harrison, Administrator for Scottsdale Heritage Court, A Life Care Center of America Facility. By adding these new training elements, they continue to enhance their commitment to customer safety as they provide a vital service to our residents”.

Since its inception, DMTS has been providing high quality non emergent transportation services throughout Arizona. With a fleet size of over 60 specially equipped vans, DMTS provides transportation to approximately customers throughout Maricopa and Pinal Counties.

About Dependable Medical Transport Services (DMTS)

DMTS, a wholly owned subsidiary of Priority One Enterprises, is a leading non emergent medical transportation company based in Phoenix, AZ. With a focus on quality service, advanced technologies and a superior fleet, DMTS is the preferred provider to many healthcare facilities, skilled nursing centers and Health Maintenance Organizations.

Michael Shabkie
Managing Partner
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Exploring Alternative Ambulance Transportation Solutions

As Emergency Medical Services and Hospitals struggle with an increasing demand for services, many EMS systems work in a constant state of “over load”.

We regularly see media stories on ED overcrowding and ambulance diverts throughout the United States. As one EMS professional stated, “we are working a multi casualty incident- each and every day”. The way EMS responds to 911 requests is changing dramatically as the healthcare system evolves rapidly. Is your organization ready for that change?

Hospital systems are working diligently to increase patient capacity by adding more beds and implementing operational changes to enhance throughput. To some effect, these measures have provided relief to an already stressed EMS system in most communities.

Managing patient volume aggressively in the Emergency Department allows the EMS Agency to go back in service for the next call but where does this cycle end?

In most cities, the EMS model is one that dispatches the most expensive equipment (fire engine) and the most expensive mode of transportation (paramedic ambulance) to transport a patient to the most expensive treatment option (Emergency Department). The current state of EMS and the healthcare system can be summed up with an EMS old-timer phrase “you call, we haul”.

In response to our industry’s slow moving evolution,  I’d like to introduce two clinical terms that have been used over the years as EMS and Medical Professionals cope with the explosive demand for services.

The EMS Afterload Approach

EMS Afterload, for illustrative purposes, is defined as the management and placement of patients after they arrive at the hospital via ambulance. Many EMS systems are working collaboratively with their hospital systems to ensure that patients who call 911 have a place to go. There is an underlying sentiment that the hospitals need to be able to accommodate these patients as volume demands continue to increase.

Hospital leadership adds Emergency Department bed capacity and staffing in an effort to keep up with the demand for patients that do not require that level of clinical care. There is a tremendous focus in accommodating patients after they arrive at the Emergency Department within minutes. By only managing the afterload, EMS systems and hospitals will never achieve a system that can handle the patient demand. In my opinion, the efforts to improve capacity are merely a Band-Aid covering the underlying issue.

The EMS Preload Approach

As defined, EMS Preload is the management and appropriate medical decisions made in the interest of the patient on scene prior to transport. EMS systems need to take a hard look at their current system. As we know, patients calling 911 expect a rapid response by highly trained individuals to treat or cure their ailments. As an industry, we have done a terrific job in promoting the concept of immediate 911 access with access the highest level of care.

Unfortunately, public education on “appropriate use” of the emergent 911 system has not been our strong point. With the changes in healthcare and the emergence of managed care, patients often have no other choice but to call 911 for their medical needs. As America’s safety net, we have proven ourselves reliable but at what cost?

Many innovative EMS systems are exploring alternative dispatch protocols and alternate transportation protocols that ensure when a person calls 911 they will receive the appropriate level of response, treated in the appropriate manner and transported to an appropriate facility, as indicated by their medical condition.

Now more that ever, EMS Medical Directors and key stakeholders need to develop alternative destination protocols that encompasses the use of non emergent vehicles, transporting patients to qualified Urgent Care Clinics (UCC) and Free Standing Emergency Departments (FED) throughout their communities. These are the final few steps in meeting the needs of our patients and providing the appropriate pathway that is both cost effective and clinically sound.

The concept of delivering any alternative to what is considered a “standard of care” can make EMS professionals a little nervous. Many ask, “Why implement change to an already proven system”? My response will always be,  “What is in the best interest of the patient and the community”? We can all agree that the current model of “you call, we haul” is not efficient and does not provide the accurate level of services that patients truly deserve.

EMS providers throughout the U.S. have a strong history of providing selfless service to our communities. Now more than ever, we should become reflective, roll up our sleeves and evaluate how we deliver that service. There is no short-term solution but with innovative strategies and responsible changes, our communities and the patients we serve will benefit enormously.
About the Author
Michael Shabkie has extensive EMS and Healthcare management experience and has passionately served as a key collaborator for EMS system design  and acted as an executive advisor on operational processes for both public and private EMS throughout the U.S.  To learn more please visit Engage911 or Michael Shabkie on Linkedin

Do You Have a High Touch Ambulance Marketing Program? 

Successfully marketing an NEMT or ambulance company and its’ services is a highly complex undertaking. The sales cycle can be prolonged, the competition fierce and current customers can be fickle.

As company owners or managers, we have to understand our sales process intimately and have a “high touch” marketing plan that is finely tuned for the customer.

High Touch vs. Low Touch Marketing
Let’s compare high touch vs. low touch marketing to see where your ambulance company fits in. For example, how do you shop for a new car?

If you are like most consumers, you start searching for various brands and explore car options, visit various car dealerships, take a test drive and after a relatively long research process you finally decide on the car you want to purchase.

During this sales process, the dealership has a sales team on hand to actively assist you and can spend hours in getting the sale done.

Compare this with buying detergent in a grocery store. It might not take you more than 5 minutes in deciding the purchase and you do not require the assistance of a salesman during the process.

As you can clearly see, purchasing a car is a good example of high touch marketing. In this scenario, the volumes are low and the margins are high.

Customers require a lot of hand-holding and there is a greater degree of brand education involved. In the case of buying detergent, there is a great deal of commoditization and there is less risk associated with the purchase.

Low touch means a sales force doesn’t need to actively pursue the customer and the margins tend be slightly lower.

High Touch Marketing Tips for Your Company
1. In the medical transportation industry, high touch marketing involves cultivating personal relationships at all levels of the facility. As it relates to interfacility contracts, the company depends on a few high-value customers rather a large number of low-value customers.

2. Since the risks of signing a preferred provider contract are high, there must be a focus on Quality Improvement, response time performance and closed loop incident reporting after the contract is signed.

3. A high level of customization and personalization is usually needed to secure a contract. The ambulance marketing team must understand the requirements of each facility and should be able to offer a greater degree of customization in order to differentiate their company.

4. Lead generation should focus on quality and not quantity. The focus of the marketing
not on cold leads. Your associate should know the contract cycle for every facility in the service area and a general feel for what the competitors are offering their customers.

5. Implement a companywide program focused on superior customer service. Since the acquisition costs are so high in high touch segments, attention must be paid by each department (i.e. operations, dispatch, clinical etc.) to retain customers. In my opinion, every employee in the company is a marketing associate.

Referrals are a very important part of high touch marketing and the ongoing success of your company depends on it.

6. In a high touch environment, set your company apart by using inbound and social marketing methods such as high quality websites that provide useful information to facility staff, create a blog focused on trending facility based topics and use social media to highlight your services in detail.

7. Send out an email survey to your current and potential customers and ask them what their biggest struggles are in their facility related to medical transportation services. With the answers they provide you can tailor your services to what they truly need.

8. In an attempt to connect with your key facilities and their decision makers on a personal level, you can also implement video emails into your ambulance marketing efforts. There are several video email providers that offer affordable services.

If you don’t want to invest in a video email system, a simple YouTube video will work as well. By making a video and talking directly to your customers they will feel like they actually know you or your company on a more personal level.

As an example,Facebook has a video update feature that you can use to post video status updates on your wall.

This is a great way to get your company in front of your customers. The human touch goes a long way in marketing your transportation service.

Putting it All Together
The days of handing out pizzas and then waiting for the phone to ring are over. Utilizing just a few of these strategies will begin to quickly build value and trust with your healthcare customers.

Marketing success calls for a plan and a purpose. Building relationships and creating loyalty though a high touch program is the hallmark of many successful and sustainable businesses in today’s unpredictable economic climate.

It is worth the time to think about how you market your services and how your company is keeping up with the emerging trends in the industry.

About the Author
Michael Shabkie has extensive medical transportation experience with companies throughout the U.S. with both the public and private sector.

He has also served as a key collaborator for NEMT and EMS system design, developed winning contracting strategies, managed political and public affairs, and acted as an executive advisor on operational processes for both public and privately held organizations.

For more information visit:

Link with Michael Shabkie

Developing a Winning Ambulance Company Business Plan

As an ambulance company owner or administrator, developing a multiyear business plan sounds like a daunting process but it is one of the most important processes that is often overlooked when developing a new company. Creating a business plan is equivalent to having a GPS or road map when you travel. As you can imagine, not having one is a sure fire way to get “lost” and lose focus on your core business strategies.

Developing a business plan is an easy component to overlook, especially when there are more pressing operational and financial pressures vying for your attention. The problem with not having a plan, is that as you address the daily challenges of operating the company, it is easy for the operations to spin out of control. A well thought out business plan is designed to get you back on track. I’d like to share 10 simple tips for developing a business plan that I have found helpful over the years.
1. Remember that a business plan is meant to be a fluid document and that you are not writing anything in stone. Your business plan will change and evolve as time goes on. As a foundation, the plan should outline your goals, challenges and where you want to be in 3 to 5 years. The plan should be updated annually to fit different economic circumstances or operational changes. We cannot truly see into the future, so don’t panic about getting it exactly right, instead concentrate on your market, your competitors and your grow strategies over this period. .
2. As a general rule, do not get caught up on the length of the business plan. Most owners think that unless a business plan is 30 pages long, that it is not of any worth. This is the wrong approach; your business plan can be as long or as short as it needs to be. There is no need to pad the plan with unnecessary words or items that don’t need to be there. Keep it clear and concise. It is not the size of the plan that counts, it is the content.
3. Develop the outline for the executive summary. An executive summary needs to be fairly succinct and should enable readers to know what the business is, what the business does and the objectives that you want the company to meet. This is the area of the plan to include your mission statement, if you don’t have one this is a good time to develop one.
4. Business plans are often a way of attracting funding or are part of the loan process. The plan should showcase senior personnel; market differentiators and operational best practices. This approach is the best way to sell potential investors or lenders on the intangible worth of your company.
5. It is critical to provide a detailed analysis of the markets you serve. A good plan analyzes the facilities or municipalities who want to contract for services, analyzes the competition and examines the buying behavior within the target markets. Be thorough in this section and do not simply assume that you have work in a market that is devoid of competition. All markets are vulnerable; the plan simply needs to show that the company can survive when times get tough.
6. The development of a strong marketing plan is essential. You will need to show that you can market your ambulance services and that you have thought about how to increase market share through an understanding of the basic principles of marketing.
7. It is important to include some kind of analysis that looks at your strengths, weaknesses, opportunities, threats: namely a SWOT analysis. This is the time to peel back the onion to examine all the layers of the company. In general, you are only as strong as the weakest link. This section should be an open and honest look at the organization. Most importantly, it demonstrates that you have thought everything through and that you are methodical in your approach.
8. Timing is everything. It is critical to consider the timing of your plan; don’t be overly optimistic, set realistic growth goals and identify achievable milestones. Taking a year over year approach and knowing the timing of contract or RFP opportunities will assist in this process.
9. As a final detail, the business plan will need to demonstrate that you have included a very methodical financial projection over this period of time. The financial plan has to be based on your past financial performance and needs to be accurate. It is easier to project revenue but all expenses need to be included, such as rent, any payroll, insurances, operating costs etc.
10. There is an old saying that a picture is worth a thousand words. This is especially true when developing a compelling plan. Take the time to develop graphics, graphs and insert pictures that tell the story. Finally, include all relevant data such as bank statements, excel spreadsheets etc.
As a final point, the sections outlined in this article should provide a solid foundation in the development of the business plan. Remember that the plan does not have to written in one day, take your time and work on each section over a period of time. This approach will enable you to get to the end result in a way that is achievable and makes the whole process a whole lot less daunting.
About the Author
Michael Shabkie has extensive ambulance business development experience in Arizona, Texas and Colorado, with both the public and private sector. He is currently the Managing Partner for Engage 911. He has served as a key collaborator for EMS system design, developed winning contracting strategies, managed political and public affairs, and acted as an executive advisor on operational processes for both public and private ambulance organizations.
For more information visit:

Tips for Writing Your Ambulance RFP Responses

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Owning an ambulance company today is often a tale reminiscent of David versus Goliath. As an owner or operator of an local ambulance company, you are faced with many challenges each and every day. Aside from ensuring you have the staff, the vehicles and the equipment to respond to ambulance calls, you are also responsible for growing your business by increasing market share.
Often times, you are faced with competing against one of the large national providers that have unlimited resources and a team of proposal writers dedicated to responding to RFP’s. The question many ambulance company owners are faced with is: How can I compete against Goliath and be successful?

Get Your Slingshot Ready

Developing the resources to respond effectively to a Request for Proposal should occur well before a RFP is released to the market. Many times, companies wait until the last minute to start gathering the resources necessary to develop a proposal. My advice revolves around the simple premise that “every day is a day we need to submit a proposal.” This means that your company should create a Proposal Database that contains graphics, pictures, company background information and documents that are standard to each and every RFP process. If you have responded to proposal requests in the past, each response should be located in a single electronic folder that will allow for easy “cut and paste” options.

Examples of documents that are usually required in a proposal include:

· Company background and formation documents

· Pending litigation

· Professional references
· Two or more years of audited or reviewed financials
· Certificates of Insurance (COI)
· Overview of clinical  and billing practices

· Overview of operational practices and protocols

· Administrative and operational organizational charts

It is never too early to have these developed and saved into your Proposal Database. Developing these resources during a time when no proposals are pending provides your company with the ability to refine the message and edit for pertinent content. The best time to develop your proposal or work with a professional proposal writer is when there is no pressure of an impending submission deadline.

Write an Amazing Summary

There is an old saying that you can’t judge a book by its cover, but when faced with a multiple responses from several ambulance companies, each consisting of 200+ pages, you better believe that your proposal is judged by its first page. Most evaluation committees are faced with the painful scenario of having to read 200+ pages of different companies’ proposals. It is well known that many evaluators only read the first page and then start skimming. The executive summary or cover page should give a high value overview of your proposal, hitting all of the discussion points explaining your company is the only choice for their community or facility. Having that information on one page makes a great first impression and says to the client “we are professional and we are trying to be helpful”. It’s one of the easiest things you can do to set the tone for the remainder of your proposal.

Be Clear and Concise

Other than Chinese water torture, nothing makes the evaluator’s mind go numb like endless shop-talk, buzzwords, and information that isn’t requested nor has any impact on the request. Most evaluators will view 200+ pages of your proposal as punishment if you make them read more than they need to. If you can answer the question in one paragraph why make them read four? Be clear and concise; make sure that you stick to the points that are necessary to convey the information to the evaluator. Simply remember that “less is more” so long as you answer the questions.

Answering the Hard Questions

In my opinion there is never such a thing as a “stock request for proposal.” What’s the point in spending the time writing a proposal if you’ve answered questions the proposal didn’t ask for, or worse, didn’t answer the questions they did ask? As simple as it sounds, you must answer their questions. The easiest way to be eliminated from the competition is by not answering their questions. No matter how mundane or irrelevant, you have to assume they asked the questions for a reason and they’re judging you on the responses you provide.

References, References, References

The best way to prove to the evaluation team that your company is the clear choice to meet their needs is to show them examples of your success. Dispel any doubt that they might have regarding your ability to fulfill the project by listing three to five contracts of the same caliber that you completed and have strong similarities. Detail those similarities so that the client can say “oh, that’s just like ours”. If the next sentence from the evaluator is “I like what they did here” you have a great chance of being a finalist.

Telling the Story While Selling the Company

Are RFP’s won on price alone? The simple answer is usually not. Ambulance companies in a competitive market fall into the trap that pricing is the greatest differentiator between the competitors. If pricing is your sole focus, you tend to have two problems: there will always be a company that underbids you and you’re not focused on bidding the RFP but are worried what the competition will bid on the proposal. This narrow focus skews your pricing and sets you up for failure.

Try this approach: instead of focusing on the price, focus on your company. Be sure you communicate what makes your company the new, unique and perfect choice for the community. You want the evaluators to come away from reading your proposal thinking “they seem like the perfect fit for us” which is a much better takeaway than “well, they submitted an average proposal but they’re the cheapest”.

The million dollar question that you need to answer in each and every proposal is “why are you the right choice for this contract? It may sound elementary, but the answer to this question is never simple. It takes a well thought out plan of development and execution.

About the Michael Shabkie 

Michael Shabkie has extensive ambulance business development experience and has also served as a key collaborator for EMS system design, developed winning contracting strategies, managed political and public affairs, and acted as an executive advisor on ambulance industry operational processes for both public and private ambulance organizations. For more information visit:

Should Ambulance Companies Partner with Accountable Care Organizations?

Is is your ambulance company integrating with the regional Accountable Care Organizations (ACO)?  How is it affecting service delivery in your area? 
The Patient Protection and Affordable Care Act of 2011 provides for the establishment of Accountable Care Organization (ACO) contracts with Medicare by January 2012. As stated in the Affordable Care Act, the ACO promotes accountability for a patient population, coordinates items and services under part A and B, and encourages investment in infrastructure and redesigned care processes for high quality and efficient service delivery. A quick lesson on the specifics of this groundbreaking legislation is available in this great Wiki article. 

A Look into the Future of EMS – Today

Forward thinking hospital systems and their local ambulance providers are exploring ways to reduce the expense of transporting patients to the Emergency Department for non emergent care as well as developing strategies to curtail readmission of patients once they are discharged from the hospital. The need to integrate the local ambulance provider into the regional Accountable Care Organization (ACO) is critical.

As it relates to managing patient readmission, hospital systems or the ACO should be looking to contract with local EMS organizations to provide the “at home” follow up of patients within 72 hours of discharge. The concept is that specially trained Paramedics would ensure medication compliance, take a baseline assessment of the patient and set up or confirm any follow up appointments the patient may have. 

Additionally, the ambulance company or first response agency could be tasked with the coordination of other transportation needs a patient may have. It is my recommendation that the Provider should establish sub-contracts with local taxi companies, wheelchair companies as well as other ambulance providers. 

 An Unfunded Mandate?

It is stated that the compensation mechanism comes directly from the ACO with Federal monies allocated for the development of the ACO. 

Essentially the ACO should pay an assessment fee for each patient follow up. This will generate a substantial additional revenue stream for the EMS agencies but will result in an overall savings of Medicare money related to unnecessary readmission for failure to comply with discharge instructions. 

The motivation for the hospital to allocate this funding is to reduce readmissions (thus reducing penalties) and to ensure a high performing ACO. 

The current system of reimbursement for transporting a patient as the only funding stream for an EMS agency could be coming to an end. EMS agencies wouldn’t just be compensated for moving the patient to the highest level of care: The emergency department. They could be compensated for care that really will benefit patients and make the healthcare system more efficient.

What Can Your Company Do?

First and foremost, EMS agencies need to start working with their local hospitals to develop an understanding of the ACO concept. The best mechanism for this is to develop a task force or committee that includes members from the EMS and Hospital System. Initial discussions should include the EMS role in alleviating emergency department overcrowding through better triage at the 911 dispatch center, paramedic initiated treat-and-release programs, and transportation to alternate destinations.  

Additionally, organizations that manage to achieve seamless patient information exchange through the integration of data, stand to gain an insurmountable advantage and unparalleled opportunity in the fast-moving healthcare landscape.

This is potentially a win-win for both EMS and the Hospital system. If the leaders making the decisions understand the opportunity and are willing to throw out preconceived notions of how the system should work, then we are in for a very exciting time in the EMS world.For more information visit Michael Shabkie at