Axios Source Article | Comments Courtesy of Matt Zavadsky
Lots to unpack here…
Interesting findings from a reputable and widely respected non-profit, which is often cited by governmental leaders as a basis for fee and payment analysis. The hyperlinks to related commentary are also interesting reads.
It may be a good idea for a coalition of EMS experts from the AAA, NAEMT, IAFC, AIMHI, etc., form a task force to digest this report, compare ambulance fee changes compared to other emergency/safety-net medical care services, and do some localized research (i.e.: ground truth) on things like cost of service delivery trends, trends in payer mix and payment practices, impact of performance expectations that have little correlation to patient outcomes (response times, staffing), etc., to prepare and publish an analysis of this report, with recommendations for things like alternate deployment models, clinically relevant performance standards, alternate dispositions, etc.
Some of the most interesting findings and charts from the report included below.
Strongly recommend that interested folks download the full report here.
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Ambulance rides are getting a lot more expensive
Tina Reed, 2/22/22
https://www.axios.com/ambulance-rides-are-getting-a-lot-more-expensive-cee897fe-63b7-4412-aa67-718109773e79.html
The cost of an ambulance ride has soared over the past five years, according to a report from FAIR Health, shared first with Axios.
Why it matters: Patients typically have little ability to choose their ambulance provider, and often find themselves on the hook for hundreds, if not thousands of dollars.
The details: Most ambulance trips billed insurers for "advanced life support," according to FAIR Health's analysis.
- Private insurers' average payment for those rides jumped by 56% between 2017 and 2020 — from $486 to $758.
- Ambulance operators' sticker prices, before accounting for discounts negotiated with insurers, have risen 22% over the same period, and are now over $1,200.
Medicare, however, kept its payments in check: Its average reimbursement for advanced life support ambulance rides increased by just 5%, from $441 to $463.
Between the lines: Ambulances aren't covered by the new law that bans most surprise medical bills, meaning patients are still on the hook in payment disputes between insurers and ambulance operators.
State of play: Ground ambulances are operated by local fire departments, private companies, hospitals and other providers and paid for in a variety of ways, which makes this a tricky issue to address, according to the Commonwealth Fund.
- Some states — such as Colorado, Delaware, Florida, Illinois, Maine, Maryland, New York, Ohio, Vermont and West Virginia — have protections against surprise ground ambulance billing, a columnist in the Deseret News pointed out earlier this year.
- But in California, Florida, Colorado, Texas, Illinois, Washington state and Wisconsin, more than two-thirds of emergency ambulance rides included an out-of-network charge for ambulance-related services that posed a surprise bill risk in 2018, according to a Peterson-KFF Health System Tracker brief.
- The Biden administration has said it's working on the problem.
The bottom line: Costs for ground ambulance care are on the rise and, with few balance billing protections, that means patients could still be hit with some big surprises if they wind up needing a ride in an ambulance.
