First tier runs cannot be billed. In 2012, “about 20 percent of our runs were nonbillable. That means we get nothing.” He also revealed the average cost per EMS response was $421, but the revenue was only $341, an average loss of $80 per response last year.
In addition, Medicare/Medicaid have fixed payment amounts for transporting patients and mileage. The difference between the allowed and paid amount is billed to supplemental insurance if available or paid out of pocket by the individual. However, “most of the time, it ends up in collections,” he reported.
Squad leaders had brainstormed possible alternatives, which included keeping the current operating structure and support, consolidating or sharing response in nonpeak hours, creating a countywide EMS association with dues to offset operational deficit, eliminating paramedic billing ($150 per run) to squads, increasing funding from county contracts, returning to volunteer organizations, creating hybrid organizations (volunteer/paid), operating paramedic ambulances and splitting the paramedic fee based on value, “but there was no clear solution that the team felt was going to solve the problem,” the speaker emphasized.
County commissioner Bob Reiners, Sunman, said, “For the year 2013, we are budgeted for that flat rate for paramedics .... We possibly may be able to reconsider that amount” in the future.
Someone also asked about the county adding a tax for EMS services. Sieverding revealed, “That’s one of the many possibilities.”
Batesville Mayor Rick Fledderman noted, “I think it would be a good idea to get a group together to talk about solutions .... It has got to be a countywide solution, and we all have to work together.” In Batesville, “we don’t do the hard billing. We went to soft billing 12-15 years ago, but I think we are going to have to go to hard billing.”
Batesville Fire Chief Todd Schutte later explained, “For people within the city limits, we have soft billing. We only get what the insurance pays. We don’t send a bill. Outside the city, we will send a bill, but they’re not obligated to pay it.”
County council member Dee Dee Kaiser, Batesville, pointed out, “Communication is important. The public doesn’t know what situation the squads are in and ways they can help. They can write a check to the local squad or send memorials.”
Sieverding added, “We can get a group together to figure out a way to keep the squads in the communities.”
Diane Raver can be contacted at firstname.lastname@example.org or 812-934-4343, Ext. 114.