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Medicare putting Ellsworth Ambulance Service in Financial bind

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Medicare putting Ellsworth Ambulance Service in financial bind

(12/12/01)

By: staff December 14, 2001

Changes in Medicare reimbursement to ambulance services nationwide

set to become effective next month will be especially hard on rural services,

including Ellsworth's.

The local service is projected to receive approximately $400,000

less in Medicare funding next year under the changes, Director Bill haw

said last Thursday. Rural services are particularly being affected because a

high percentage of the people they serve are elderly, dependent on the Medicare

program.

" It's all backwards, " haw said about the urban-rural disparity

in service support.

He explained many rural services, as in this vicinity, are largely

volunteer-operated and transport patients farther to hospitals than their urban

counterparts. Yet, the latter are in a better position to get Medicare

reimbursement, although they often have paid staff, bigger population bases to

fund them and a matter of blocks, not miles, to travel when they transport

people.

Reimbursement is tied to the level of care a service provides, the

director said. Presently, Ellsworth is at the Emergency Medical

Technician-Intermediate (EMT-I) level, having been the first unit in the county

to attain this level. To maintain it, the service must have at least one crew

member aboard its ambulances on each run be licensed as an EMT-I,

24-hours-a-day, seven-days-a-week.

To obtain an EMT-I license, a crew member will need 400 hours of

training under recent changes, he said. Actually, seven of Ellsworth's 38-member

roster have already exceeded that licensed status, achieving Paramedic (the

highest level) by taking approximately 1,400 hours of training. Of the rest,

around half were licensed as intermediate under the existing rules and half are

licensed as basic (requiring 140 hours of training).

All of these levels mean making a major commitment to the service,

haw agreed.

" It's a lot to ask of a volunteer, " he said, noting recruitment of

more members is important, as there's already a shortage for daytime runs, when

most of the present crew is at other jobs.

And while a significant number of crew members have made that

commitment, more training is in the offing just for the service to continue at

its present level, he said. Besides the challenge for the EMT-Is, who'll now

have to work toward 400 hours of training to keep their intermediate licenses,

it'll be especially difficult recruiting new members when they face 550 training

hours if they're going to reach the same level.

The director said the service's operating committee " doesn't want us

to go backward. " So it appears members will need to catch up with their

licensing as well as try to advance it for a lesser amount of Medicare funding

to the service. He also foresees more write-offs for claims Medicare denies,

intensifying the service's tight financial situation.

©Pierce County Herald 2001

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