Washington County ambulance slashes service rates

WASHINGTON — Washington County Supervisors have signed off on revisions for the local government’s ambulance department rates, which lower the cost of every service it provides. While all of those fees remain above average for the Southeast Iowa EMS region, some are less than half of their former price, last updated in June of 2022.

Interim Ambulance Director Katrina Altenhofen said the change would not reduce income for the department. Insurance providers generally reimburse the ambulance at rates based on Medicare and Medicaid policies, a norm that meant higher costs for service were exclusively bared by uninsured patients, who usually couldn’t afford them either.

"Our claim percentages, our returns on claims were extremely low,“ she said at a Board of Supervisors meeting Tuesday morning. ”Our (fees) are extremely high in comparison to what they have in this regional area, as well as what our Medicare and Medicaid really allows … that change to our fee schedule (will) hopefully start getting things back on track.“

Some of the big changes include emergent advanced life support and level 2 advanced life support, slashed by $959 and $1,435, respectively.

The decision came with one point of contention: lift service fees, which the ambulance charges for callers who have fallen and can’t get up, but who don’t need a ride to the hospital, or charge that comes with it.

The department’s initial proposal to county decision-makers would have lowered the cost of lift services to $0, but the board amended that number to $250 before approving the change. The fee was previously set at $275.

Supervisor Richard Young, who previously ran the ambulance service before it became a government agency, said the department was welcome to write a policy lowering the cost in some scenarios, but that free lift services would be abused by callers.

“I’m just afraid that as soon as people find that it’s zero dollars, your call volume is going to go up even more, and they’re going to refuse to go to the hospital,” he said. “Nursing homes are going to go back to not staffing the way they should because they know the ambulance is going to come on nights … for us to pick their patients up off the floor.”

Ambulance Billing Coder Jamie Brame said that was a legitimate concern, citing former polices at local nursing homes that once required employees to call an ambulance rather than lifting residents off the floor themselves.

Still, she said keeping the fees may not solve the for private residences that don’t arrange their own accommodations. She said such frequent callers often made a habit of leaving their lift service fees unpaid.

“Many of them know that there’s a charge, but they know they’re not going to pay it anyway,” Brame said. “What the charge was doing for people that were honest and using it when they need to, was then pushing them to not call 911 for services that they do need … I really want people to be able to feel like they can call 911 when it’s appropriate.”

Comments: Kalen.McCain@southeastiowaunion.com