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EMS director reports rising survival rate but warns service faces a revenue shortfall
Summary
County EMS leadership told commissioners the county’s return-to-pulse rate for out-of-hospital cardiac arrests is above comparable rural averages, but lower transport volumes and reimbursement limits left EMS operating with a negative margin through November.
Mr. Kevin Deon, the county EMS representative, told the Chester County Commission the system’s clinical outcomes are strong but finances are strained. "Chester is sitting at 32%" for return of spontaneous circulation after cardiac arrest, he said, noting that figure exceeds typical rural ranges. He credited first responders for rapid on-scene care.
Deon presented operational data for the first half of fiscal year 2026 and compared it to prior years. He reported total responses and transports were down relative to fiscal 2024 figures and said Medicare preauthorization and tighter billing rules have reduced repetitive, billable transports. On revenue, Deon said net operating margin was negative (he reported a roughly $48,000 shortfall) and that system-support costs put the service deeper into the red (he cited a system-support negative around $143,000). Deon said the county subsidy mechanism and the per‑incident assessment payment fell as run volume declined, reducing operating revenue.
Commissioners and Deon discussed causes and implications: fewer dialysis and repetitive transports, changes in outside-unit responses that had previously supplemented coverage, and the county assessment model tied to run volume. Deon also outlined education and training initiatives, including in‑house EMT and first‑responder instruction, and asked the commission to consider how county subsidy policies and billing practices affect net revenue.
The presentation closed with an invitation for follow-up: Deon offered to provide December financials at the next meeting and to supply more granular run and billing data if commissioners requested it. The commission asked staff to review options for stabilizing EMS finances before formal budget decisions are made.
