A 12-hospital statewide system facing budget pressure from a legacy Emergency Medical Services (EMS) provider charging more each year while delivering aging infrastructure. Telmac upgraded the entire EMS environment to 5G, reduced all EMS costs by over 15%, mitigated future CPI to 2%, and completed the project in under 90 days.
Statewide Hospital System | 27,000 Employees | 12 Hospitals | 200 Outpatient Facilities | 4,000+ Physicians
The health system’s legacy EMS provider had continued raising costs year over year while delivering infrastructure that hadn’t been meaningfully upgraded in years. The organization was facing a significant capital expenditure to address the aging EMS environment — on top of the ongoing OPEX increases the provider had already imposed.
Simultaneously, the health system was working to recover from a budget deficit. The combination of a large CapEx requirement and rising EMS operating costs created a compounding financial burden that required an external strategy to resolve.
The existing EMS provider had not upgraded its infrastructure to match the health system’s operational requirements, but had continued to increase its pricing annually. The organization was paying more for less.
Addressing the aging EMS infrastructure through traditional means would have required a significant capital outlay — a difficult commitment for an organization already managing a budget deficit and seeking operational cost relief.
Without specialized EMS market expertise or a competitive procurement framework, the health system had no established basis for challenging the vendor’s pricing or demanding an infrastructure upgrade as a condition of contract renewal.
Legacy EMS infrastructure replaced with a 5G architecture — at lower total cost, with improved procurement methodologies and a mitigated CPI, completed in under 90 days.
This engagement required Telmac to deliver three outcomes simultaneously on a compressed timeline: resolve the self-audit exposure that had limited the organization’s negotiating position, restructure the EMS contract with improved pricing and CPI protections, and secure a full 5G infrastructure upgrade as a contractual deliverable — not an additional cost.
The health system’s leverage in this negotiation was greater than it appeared. The vendor wanted to retain the contract. Telmac’s job was to convert that retention pressure into an infrastructure upgrade and cost reduction simultaneously.
Telmac first resolved the existing self-audit risk, establishing a compliant baseline and removing the vendor’s ability to use audit exposure as a negotiating tool. This was a prerequisite for extracting meaningful concessions on pricing and infrastructure.
With the audit resolved, Telmac introduced a competitive procurement framework — establishing market benchmarks, identifying alternative providers, and giving the health system the negotiating position needed to demand both cost reduction and infrastructure modernization.
Telmac delivered the full outcome: 5G infrastructure upgrade as a contractual obligation, >15% cost reduction, CPI mitigated to 2%, and a complete project execution in under 90 days — enabling the health system to recover budget while upgrading its EMS capability.
Health systems routinely fund infrastructure modernization through capital expenditure when the upgrade could be a contractual requirement of the vendor relationship. The difference is negotiating leverage — and a procurement strategy that applies it.
A vendor that raises prices without upgrading its infrastructure is extracting value rather than delivering it. The longer that relationship continues without intervention, the more expensive the reset becomes. This engagement took under 90 days.
The health system needed both cost relief and modernization. Treating them as competing priorities was the constraint. A comprehensive procurement strategy delivered both simultaneously.
Legacy EMS vendors hold pricing leverage primarily because their customers haven’t established a competitive procurement framework. A structured engagement changes that dynamic — and in this case, delivered a 5G upgrade at a net cost reduction.
