The Wheels Of The Hub
As the “Medical Mile” and similar efforts continue to grow West Michigan into a regional health care destination, companies like Mark Meijer’s Life E.M.S. Ambulance have had a unique vantage point and an increasingly important role. Besides serving as a critical point of access into the health care system, medical transportation firms are also the links between the developing health care hub and its various satellites.
“A large part of what we do is move people from the local community hospitals to larger care centers for more complicated treatment,” said Meijer, founder and president of the 27-year-old Life E.M.S. “It used to be we’d transport a lot of those patients to Ann Arbor or Detroit, but we don’t see nearly the call for that anymore.”
There is still the occasional patient from Chicago, Detroit or elsewhere in the Midwest who happens to fall ill while in West Michigan, and some trips to top-tier care centers such as the Mayo Clinic and Cleveland Clinic, but for the most part, patients today elect to receive treatment in West Michigan.
“We certainly have seen the increased capabilities of the health care service in West Michigan,” said Meijer, a progeny of one of the families responsible for funding much of the region’s medical development. The youngest son of Meijer Inc. Chairman Emeritus Frederik Meijer, Mark Meijer likely could have had a promising career in retail — or as an architect, his plan in high school — but instead chose a then-underappreciated career in paramedics.
“When we started the Life E.M.S. Ambulance in 1980, ambulance service was just getting into the paramedic level of care,” said Meijer. “That type of care has really only been around since the late ’60s and ’70s. From a clinical and operational standpoint, this was a field in its infancy.”
Ambulance service at the time was not generally thought of as part of the health care system. Operations weren’t always professional and were seldom clinically sophisticated. The emphasis was public safety — horizontal taxis with red lights on top.
From a clinical perspective, the company has evolved considerably. Its 46 ambulances boast the latest pre-hospital care equipment available. It has parlayed its operational expertise into a first-alert home monitoring system and fully accredited paramedic training to area high schools and other institutions. It can also provide immunizations and other preventive care.
The company’s footprint has extended alongside the reach of West Michigan medicine. In 1990 it expanded into Kalamazoo, and today stretches across nine counties from Ludington to Dowagiac. By taking over 911 emergency ambulance services in several rural communities, it has become an even more important part of the health care system.
“Besides helping out a community from the 911 standpoint, it also further integrates us into the health care system,” Meijer said. “We’re bringing more rural patients into the area.”
Like the rest of the health care system, ambulance providers have been hit hard by lower reimbursements for services provided to Medicare and Medicaid patients. Roughly 50 percent of the company’s revenue comes from these sources, and any reduction at the state or federal level directly impacts its bottom line.
On average, ambulance services are the lowest reimbursed Medicaid providers relative to cost — with payments in many situations lower than the cost of service. For rural areas such as Lake County, which has no hospital, the municipality must work with ambulance providers to subsidize any shortfall, or risk losing access to emergency care entirely.
“We are literally the front line of the health care system,” said Meijer. “In emergency situations, we’re their initial access to the system. It’s dramatic in some of the areas we serve, where all patients have to be transported outside of the county.”
Meijer led one of the ambulance field’s most successful advocacy efforts earlier this decade as president of the American Ambulance Association and later as an active board member. He spoke before Congress in 2001 as part of a successful campaign to realign Medicaid fee schedules to eliminate disparities between payments to providers on the East and West coasts and those in the Midwest and Southeast. After a two-year hiatus, Meijer is again an active board member, representing the Midwest region.
From local and regional public safety standpoints, the contribution of Life E.M.S. and its competitors has never been greater. The 330-employee firm will respond to more than 10,000 calls for service this year — twice that of five years ago. Its operations center also provides support for the Heart of West Michigan United Way’s 2-1-1 referral service and the American Red Cross of Greater Grand Rapids’ emergency and military assistance hotlines.