Tom McEntee, who started his career in emergency services as an EMT in New Hampshire, is the new Eastern U.S. CEO for American Medical Response, the private ambulance company that serves Manchester, Nashua and Candia. (COURTESY)
Business Q&A: Tom McEntee, new Eastern U.S. CEO for American Medical Response
On a recent visit to Manchester, McEntee was interviewed at AMR headquarters on Pine Street.
Tell us about your New Hampshire roots.
I was born and raised in New Hampshire, grew up in the Wilton-Lyndeborough area, and actually began my EMS career while still in high school as a volunteer on a local volunteer rescue squad. In the early 1990s, I went to work for Rockingham Ambulance. I had worked there part-time as an EMT, and when Rockingham won a contract in Manchester in 1993, I was brought on board to help build out the Manchester program. That began my EMS management career.
What was your most recent position?
In 2007, I left Rockingham Ambulance and went to work for AMR. I was the general manager for the Riverside County, Calif., operation, which is a large, county-wide system transporting about 150,000 patients a year, serving two million people.
What led to your appointment as CEO for the Eastern region?
We had identified the need for a senior management change in the Northeast, and so they asked me because of my knowledge and experience here if I would initially come back and help out. I did that, and that led to, "Would you be interested in being regional CEO?" So that's how I ended up being appointed.
What does the Eastern region encompass?
It's from New England west to Minnesota, south to Missouri and then back easterly to the Carolinas. There are only three territories in the country - east, south and west. The administration office is located in New Haven, Conn., but my office is really my car.
What have been some of your first priorities?
We formed a new local leadership team, naming Chris Stawaz the general manager for Maine and New Hamsphire. We named a new general manager for Eastern Massachusetts and one for Western Mass. So we reduced the span of control and chose leaders with a different mind-set toward the business. We rebuilt the local leadership teams, and now we're also rebuilding some of our infrastructure, making improvements in equipment and really trying to re-energize the region and get us focused on growth.
Sounds like a bit of a shake-up. What prompted that?
The span of control was so large, that there was a reliance on numbers. Numbers tell a story, but they only tell part of the story. Even though the East Region was hitting its numbers, the senior team started to hear grumblings about things.
We started to hear customer service complaints, rumblings from the market, and when the CEO of the parent corporation visited the region, he took a look around to get a scan of the environment and decided things were going in the wrong direction, and it was time to make some substantial changes.
Even though the numbers were good, the direction of the company was not where it needed to be headed. So the best thing was to make a change at the top, to redirect the organization and move forward.
Two criticisms of AMR have been high cost and billing practices, especially after your predecessor announced plans to implement a 50-percent increase in rates.
That was quickly reversed. We took a look at that and said that is totally the wrong direction to take. We reversed those rate increases back down to more market-appropriate rates, and we refunded any of the dollars recouped through those rate increases. We realized that we needed to be assertive on that and simply admit that it had been a mistake and correct it.
We also had the ongoing battle with Anthem that we needed to resolve, which we have now. We entered into a new contractual arrangement with them that takes a lot of stress away from the billing issues.
How are you addressing billing questions?
It's a medical bill, and medical bills are confusing to people. We've never accepted overpayments from folks that we haven't refunded. When we did our audit in Manchester, we identified that there have been overpayments for a number of reasons. We refunded those dollars to people. We notified the city. The city did a follow-up audit and found that the error rate was within industry standards.
What we did ultimately, to do a better job of customer service, was to put a local customer service center here in New Hampshire. It's staffed by two people, Monday through Friday, who are patient advocates. So if someone in New Hampshire has a question about their ambulance bill, they call a New Hampshire number, and it's answered by a New Hampshire person who will work with them to better understand what's on the bill. That started in January, and we've had great results with that. They'll even go to someone's home.
What is your biggest challenge going forward?
There's an emerging reality in health care that the costs are going to have to come down. I think all health-care providers are facing this new reality. So we're now taking a look at our cost structures and saying we may need to make adjustments in the future in terms of our costs because we're just in a new economic environment.
It used to be that the general public didn't really care about insurance companies getting beat up. But now that's shifted, and they have a lot of political power, the insurance companies do, and they've done a very good job from a PR standpoint of getting the message to the consumer that higher costs lead to higher premiums, so there is a real effort to bring the costs into line.
The pressure on ambulance services isn't unique, it's the same pressure that's being applied to everyone in the health-care system.