SA国际传媒

SA国际传媒

An out-of-the-box strategy to increase compensation

Instead of giving stock to its executive team, Ambulnz gave it to its frontline responders, and paired it with a novel push-to-request dispatch system

NY_Brandon Zhao.jpg

Left to right: Ambulnz President Anthony Capone and EMT Brandon Zhao. Ambulnz, which was founded by Vashovsky in 2015, currently operates in eight states throughout the U.S.; Pennsylvania, California, New York, New Jersey, Illinois, Tennessee, Colorado and Texas.

Last year, the median annual wage for EMTs and paramedics in the U.S., according to the , was reported at $35,400. The lowest paid 10% of EMS providers earned more than $11,000 less.

This issue of low wages for EMS providers has forced many to take on two or more jobs, contributing to emotional and physical exhaustion.

This combination of salary and the physical and emotional demands of the job has become a major sticking point in EMS 鈥 driving many frustrated personnel away from the profession.

Stan Vashovsky, a 25-year veteran paramedic, described this situation as a lose-lose scenario for EMS providers. To help turn the current paradigm around, Vashovsky teamed up with software developer Anthony Capone to create an out-of-the-box, digital ambulance service solution.

Ambulnz鈥檚 unique solution

, which was founded by Vashovsky in 2015, currently operates in eight states throughout the U.S.; Pennsylvania, California, New York, New Jersey, Illinois, Tennessee, Colorado and Texas.

The company, whose teal-colored rigs have become a viral sensation, has a total of 1,500 employees; 1,450 of which are EMTs and paramedics. They also employ nurses, respiratory therapists and wheelchair van drivers, many of whom are W-2 employees.

Ambulnz鈥檚 business model focuses on interfacility transfers, achieved by using its push-to-request dispatch system.

鈥淭hrough the use of technology, you increase efficiency,鈥 Capone said.

Many have made the mistake of comparing Ambulnz to , but Capone said their solution is a lot more complicated than just ordering an ambulance.

鈥淭here鈥檚 a lot that goes into providing that kind of care,鈥 he said. 鈥淎n ambulance is bed-to-bed, bedside-to-bedside, as opposed to curb-to-curb, which is Uber. Just from the transportation perspective, not even the clinical care perspective, it鈥檚 so much more complicated. For example, with Uber, you can use your credit card, whereas we鈥檙e in the complicated medical billing space.鈥

Most of Ambulnz鈥檚 ordered ambulance transportation is requested via one of Ambulnz鈥檚 applications.

鈥淲e have an iOS application in the app store and we鈥檙e embedded inside various different EMRs like Epic and Allscripts,鈥 Capone said. 鈥淲e鈥檝e got our own online ordering portal, so we have all these different mechanisms by which various different providers will procure transports 鈥 and that comes in digitally.鈥

And, unlike Uber, which allows anyone with the app to request a transport, only authorized medical professionals can request and procure transport for a patient.

Efficiency in EMS

This efficiency, according to Capone, has given Ambulnz a unique opportunity to not only provide better care to its patients, but offer better pay, hours and benefits to their EMTs and paramedics.

鈥淭hey don鈥檛 need to work such crazy long shifts, like working 24s or 18s,鈥 he said. 鈥淭hey can go back to working eight to 10, which means that they are going to provide better care to patients. They鈥檙e going to be more alert and oriented.鈥

The company鈥檚 unique software solution, he says, gives a new meaning to efficiency in EMS.

鈥淏ecause we鈥檙e using software to underlie the entire thing, that鈥檚 how we achieve that efficiency,鈥 Capone explained. 鈥淵ou鈥檒l be able to actually be on time more. You鈥檒l get better ETAs, higher on-time compliance and greater transparency into both the real-time transports as well as the reporting on how well you are doing with your customers.鈥

This fundamental concept of using technology to increase efficiency, he says, turns a lose-lose into a win-win.

鈥淚 had this opportunity to say, 鈥極h, wow. I can maybe use some of the skills that I have on the software side to allow for human beings to receive better care and to allow for those that are providing the care to be paid more and to have a living wage, to build a career,鈥欌 Capone said.

Giving EMTs and paramedics an entrepreneurship opportunity to turn their job into a career, Capone said, has been at the forefront of Ambulnz鈥檚 mission since day one.

ambulnz-team-1.jpg

The company, whose teal-colored rigs have become a viral sensation, has a total of 1,500 employees; 1,450 of which are EMTs and paramedics. They also employ nurses, respiratory therapists and wheelchair van drivers, many of whom are W-2 employees.

Photo/Ambulnz

Finding a way to attract, retain and motivate personnel

Figuring out how to incentivize and offer more to their staff, Capone said, was difficult.

鈥淚t鈥檚 nice to say it, but to actually be able to find additional margin in the business that you can give back is not easy,鈥 he said. 鈥淩eimbursements are very low and costs are high, whether it be insurance, payroll or workers鈥 compensation. It鈥檚 just very high.鈥

However, Vashovsky and Capone were committed to taking one step every year toward increasing what they can offer to their employees.

For instance, they offered an incentive program 鈥 a per-trip bonus 鈥 their first year. The next year, they committed to providing health, dental and eye insurance. And, before approaching their third year, Capone said they started brainstorming ways to make EMTs and paramedics 鈥渢rue partners and entrepreneurs in the business.鈥

That鈥檚 when they came up with their Equity Incentive Plan as a way to attract, retain and motivate personnel.

鈥淚n the beginning, it was a little complicated for some people because equity ownership is something that is not perhaps familiar to many of them,鈥 Capone said. 鈥淲e built a FAQ structure and did some Zoom sessions in explaining it to everyone and where they鈥檙e at.鈥

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Left to right: Operations Manager Nina Mothershed; AEMT and Transport Coordinator Teddy Paquin; and General Manager Chris Tillery.

Instead of giving stock to their executive team first, Ambulnz gave it to their frontline responders.

鈥淲e wanted to give it to the people that are actually providing care 鈥 the ones that are going and putting themselves at risk in the back of the ambulance every day,鈥 Capone said. 鈥淭he people that should get the ownership and the rewards first are the people who are out there in the field.鈥

Employees were then presented with formal certificates of which equity units they were receiving. Many of those EMTs and paramedics, Capone said, now regularly message him about the health of the company.

鈥淭hey message me asking, 鈥楬ey, are we about to hit our budget? How鈥檚 our earnings doing?鈥 That鈥檚 not something you would normally ever hear an EMT or paramedic ask you about,鈥 Capone said. 鈥淭he people that are asking the questions are also the people that have been awarded equity.鈥

And, out of the EMTs and paramedics who were awarded the equity units, none of them have left Ambulnz.

鈥淭hey鈥檙e staying because they know that the equity units are theirs and they want to be an Ambulnz employee,鈥 Capone said. 鈥淎nd, that has shown in retention. We鈥檙e doing this because the people that we have, we care about.鈥

Offering the equity units, Capone said, has been a complicated, yet rewarding process.

鈥淵ou鈥檒l find that the people that work for you will end up working harder for you, and they will care more,鈥 he said. 鈥淭hey鈥檒l care more on the things that are measurable, like how many trips they do in a shift, which correlates to your utilization and your profitability.鈥

The company鈥檚 EMTs and paramedics, he said, look at it as the perspective of, 鈥溾業 want my company to succeed, because I am invested in this company,鈥欌 Capone said.

鈥淭hey鈥檙e going to care more about customer service, because now when they go into the hospital, do a pickup or interact with a patient, they鈥檙e not just representing some company that pays them minimum wage, they鈥檙e representing their company.鈥

This mentality, he said, changes the game.

Giving a piece of the company back

The benefits of the program, Capone said, are quantifiable and tangible. However, they鈥檙e also extraordinarily beneficial.

鈥淥ur hope in doing this is that it becomes a standard in the EMS space 鈥 for EMS companies to start giving a piece of the company back to the people,鈥 he said.

Put it into practice

From a practical perspective, EMS agencies considering a similar move must first educate their employees on their investment.

鈥淚f you hand somebody a stock certificate, then you need to do a quick Q&A with them,鈥 Capone recommended. 鈥淚f they don鈥檛 have the right comprehension, then they might not appreciate the actual value.鈥

Once EMS providers understand the financial and investment benefits, Capone said it鈥檚 equally as important to celebrate and congratulate each recipient.

鈥淐elebrate it very, very publicly,鈥 he said. 鈥淣ot because you want to self-congratulate the company, but because you want to truly congratulate the people. It鈥檚 an amazing accomplishment and it needs to be appreciated.

As for what benefit Ambulnz has in the works for its employees next year, Capone said they鈥檙e working on something even bigger.

鈥淥ur focus is to make sure that our people not only can provide for themselves and their family now, but hopefully they can provide for themselves and their family later as well,鈥 he said.

Read next: 3 ways you鈥檙e losing EMS providers and how to stop the revolving door

Sarah Calams, who previously served as associate editor of FireRescue1.com and SA国际传媒.com, is the senior editor of Police1.com and Corrections1.com. In addition to her regular editing duties, Sarah delves deep into the people and issues that make up the public safety industry to bring insights and lessons learned to first responders everywhere.

Sarah graduated with a bachelor鈥檚 degree in news/editorial journalism at the University of North Texas in Denton, Texas. Have a story idea you鈥檇 like to discuss? Send Sarah an email or reach out on LinkedIn.

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