Ambulance services devote a majority of their resources to
responding to emergency calls from Medicaid and Medicare patients across New
York State. However, the state and federal reimbursements received from these
calls are far below the cost of actually providing the emergency and
non-emergency ambulance services. Recently, the state Department of Health’s
Medicaid Rate Adequacy Study Report found that ambulances across the state are
underpaid $31 million annually for Medicaid transports. In other words, every
time an ambulance service answers a call for a Medicaid patient – whether it’s
an emergency call or a hospital to hospital transfer – they lose money.
Dan Marsh operates Medical Transport Service (MTS) in Allegany County. His business handles about 2,400 basic and advanced life support calls each year. This morning, he called the situation "dire and scary." Marsh explained why this issue matters during an interview with Wellsville Regional Network. He said many of the patients transported in Allegany County have both Medicare and Medicaid. Medicare covers 80% of the approved cost while Medicaid picks up the other 20%. If the state budget is approved, as is, that 20% will go away. Marsh noted that no matter what an ambulance bill says, Medicare and Medicaid together only cover about 50% of the actual cost. MTS recently elevated its care and availability and now employs about 30 people full-time. He said with the new potential loss of funding, his business will be "severely impacted." Marsh said it would absolutely "impact our ability to provide the current level of service." He added that in 2018, 22 ambulance services closed.
“For years, the statewide ambulance industry has been
operating at a loss of over $31 million annually when it comes to Medicaid and
Medicare reimbursements from the state. The elimination of this vital crossover
funding will make it more difficult for ambulance services statewide to
continue to serve the millions of New Yorkers who rely on our services every
single day. This devastating cut in funding will be felt by ambulance services
throughout the Western New York region and in every corner of our state. And
with an aging population, the need for ambulance services will only increase,”
said David Butler, Chairman of UNYAN and CEO of TLC Medical Transportation
Services, which provides ambulance services in Central New York.
If this essential funding is not reinstated into the
2019-2020 State Budget, many ambulance services may be forced to shut their
doors, as was the case recently in Fulton County (8,200 calls per year), or face the difficult
decision to cut their staff while continuing to serve the same size area and
population.
Furthermore, in order to survive, statewide ambulance
services may stop transporting Medicaid patients all together. This could
disrupt the entire healthcare system, causing excessive waiting, overcrowding
or back-logs at nursing homes and hospitals that are trying to accept new
patients or clear beds.
The elimination of crossover and supplemental funding will
echo throughout the healthcare industry and be a strain on the state’s already
taxed healthcare system. As ambulance services are forced to close down, there
will be fewer ambulances on the road, which means longer response times to
emergencies.
Additionally, if ambulance services are forced to shut down,
local municipalities would be morally obligated to fill the gap in service. If
commercial ambulance services are no longer able to operate, municipal tax
dollars would be necessary to build, grow, cover and sustain emergency medical
services for these communities. In order to continue to provide these
life-saving services, the burden of increased municipal spending would directly
fall to the taxpayers.
“Our ambulances and staff are a vital link in the delivery
of healthcare to thousands of New Yorkers, providing emergency responses as
well as transfers between hospitals of critical patients and transporting
medically compromised patients from hospitals to sub-acute rehab centers,
freeing up urgently needed hospital beds,” said Michael Vatch, CEO of
SeniorCare EMS, a provider in the New York City area and Long Island.
“It would not be possible to talk about the future of the
ambulance industry under these proposed funding cuts without talking about its
impact on the healthcare industry as a whole. The healthcare industry and
hospitals play a vital role in the Capital Region economy. The reality is that
as ambulance providers are forced to close, there will be fewer ambulances on
the road. Hospitals will bear the brunt of this burden as patients are forced
to wait longer for hospital to hospital transfer and hospitals are unable to
clear beds quickly enough to meet their needs,” added Butler.
About UNYAN: The United New York Ambulance Network (UNYAN)
is a not-for-profit membership corporation established in early 1998 to advance
the highest standards of training and care in the medical and emergency medical
transportation industry. UNYAN members provide ambulance services in 22 of the
state’s top 25 cities, encompassing 54 counties and provide quality and timely
medical services to millions of New Yorkers 24 hours a day, seven days a week,
and 365 days a year.
