Patients with private insurance would take brunt of fee hike
EMS: Only fraction pay their full ambulance bill
| Monday, Jun 29 2009 04:40 PM
Last Updated Monday, Jun 29 2009 09:41 PM
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Jenn Ireland / The Californian A patient is unloaded from a Hall Ambulance outside the Kern Medical Center Emergency Room Monday afternoon.
A proposed increase in county charges to ambulance companies, equivalent to $3 for each patient transported, would be multiplied more than tenfold when passed along to patients with private insurance by ambulance companies.
That's because the vast majority of ambulance passengers pay only part of their bill -- if they pay at all.
Kern County Emergency Medical Services Director Ross Elliott will ask the Board of Supervisors today to increase the fee paid by the county's five ground ambulance companies for each patient they transport.
Ambulance companies will then ask the board to allow them to increase their per-transport fee by between $32 and $39.
Air ambulance rates would also be increased.
"There is no financial gain for the providers in this," said Liberty Ambulance CEO Peter Brandon. "None."
How can a $3 fee increase on each ambulance transport possibly raise insurance bills more than $30?
Because only a fraction of people pay their full ambulance bill.
Hall Ambulance Controller Jackie Att said the vast majority of the people her company transports will never pay that increased fee.
The poor don't pay. And government-funded health care plans, Brandon said, pay only a fraction of the cost of the services their patients receive.
"You're compressing it down to the commercial insurance plan," he said.
More than 50 percent of Hall Ambulance patients are on Medi-Cal.
Much of the rest of its patient base pays less of the full cost -- or is too poor to pay at all.
That leaves only "12 percent of the transports that we actually can look to to pay that fee," Att said.
Brandon said that of the more than 80,000 EMS responses a year in Kern County, only 8,500 transports are of patients on commercial health insurance plans.
"It falls to people who have insurance or the ability to pay," said Elliott. "Any cost increase is shifted to the people who are able to afford it."
So Kern County would raise its rates by $3. Then the ambulance companies would raise their bills by $32 to $39 so that they are able to break even. An emergency ambulance ride from Hall Ambulance in metro Bakersfield currently costs $937.
Insurance companies will pay those higher bills and then raise rates their customers pay.
"None of the providers are thrilled with the concept," Brandon said. "Nobody wants to be the bill collector for the county. The idea of supporting the government to raise fees goes against my grain."
But the EMS department sets standards for ambulance companies and coordinates emergency communication between ambulances, hospitals and other emergency personnel.
In short, Brandon said, EMS is indispensible.
The fee increase "appears to be the only way to keep the department whole," Brandon said. "We have to have a functional, strong EMS department."
Elliott said the department hasn't raised fees in at least 10 years.
And, in a written report to supervisors, he outlined a number of efforts the small department has made to keep its spending tight.
Those include creating automated electronic systems to handle claims and build patient records, which allowed the reduction of a full-time job.
The fees Elliott will ask for today include additional increases charged to hospitals and on air ambulance transports as well.
In total they are expected to bring in around $243,000 in additional cash for the EMS department.
Att said the ambulance companies are trying to help out EMS without facing a steep new cost they would probably not be able to cover.
"This is basically Ross' budgetary issue," she said. "We were trying to be the good guy here and trying to assist EMS."
