Agenda Date: 9/22/15
Subject:
Title
Resolution adopting emergency medical transportation fees
Body
|
Presented By: |
Doug Farmen, Finance Director |
POLICY QUESTION:
Does city council support adopting revised emergency medical transportation fees?
BACKGROUND:
Littleton Fire Rescue (LFR) began transporting patients to hospitals in February of 1999. In July of 2000, LFR began charging for patient transport service. The transport program has been successful in reducing transport time for critically ill or injured patients, increasing the skill level of paramedics and reducing the cost of the Emergency Medical Service (EMS) program through revenue recovery as a TABOR Enterprise Fund. The rates and revenues, last updated in 2013, are lower than the program costs.
Emergency medical transportation program facts are:
• Annual transports are projected at 6,900 with 92% Advanced Life Support (ALS) and 8% Basic Life Support (BLS). ALS2 (extreme ALS) calls represent 2% of the total transports.
• The annual operating costs exceed $3.8 million.
• Costs of equipment, supplies and labor continue to rise and should be offset by transport rates.
STAFF ANALYSIS:
Analysis of annual transports, payer mix, collection rates and other factors, found that higher fees are recommended to maintain the current level of service.
City of Littleton Payer Mix
|
Payer Method |
2014 |
|
Medicare |
45% |
|
Commercial Insurance |
30% |
|
Medicaid |
16% |
|
Self-Pay |
9% |
|
Total |
100% |
The Medicare/Medicaid payer mix shifted from 49% in 2007 to 61% in 2014. The increase resulted in reductions in payer mix to commercial insurance and self-pay patient accounts.
After two years of discussing a ‘bundling’ approach with the city’s billing agent, staff is recommending this new billing approach. This approach incorporates itemized charges such as supplies (medications) and services (oxygen, blood draw, etc.) into single BLS, ALS, and ALS2 fees. The major advantages of this approach are: less insurance denials, reduction in staff time, and less patient confusion about charges. This approach will not affect billing for Medicare/Medicaid patients.
FISCAL IMPACTS:
The staff review of full direct costs indicates the EMS program is incurring an annual shortfall of approximately $217,270. Due to the current fee collection rate of 45%, $482,820 is needed to fund the deficit.
Staff is recommending a BLS fee of $1,000, ALS fee of $1,090, ALS2 fee of $1,239 and mileage rate of $16.50 per mile in order to reduce the shortfall. This equates to approximately a 7% weighted increase in all fees.
STAFF RECOMMENDATION:
Staff recommends approval of the new emergency medical transport service fees.
PROPOSED MOTION:
Proposed Motion
I move to approve the resolution adopting emergency medical transport service fees.