What’s the ‘True Cost’ of Operating an Ambulance Service?

(TNS) -A series of quick Meadville City Council subcommittee meetings Wednesday led to further discussion of the city’s impending startup of emergency medical services (EMS) and how the cost of such services can be measured.

The discussion came in response to Councilman Jim Roha’s demonstration of a spreadsheet he had created in an effort to measure the “true cost” of operating an ambulance service so that appropriate billing could be maintained to support the service.

The fact that the EMS division will operate as part of a fire department is an economic advantage but also makes measuring EMS costs more complicated, according to Finance Manager Tim Groves .

“There’s two things — we want to know what an ambulance service would cost if we ran it like, maybe, Meadville (Area) Ambulance, and that’s all they did,” Groves said. “But we don’t run it like that.”

Instead, unlike an ambulance service focused solely on emergency medical services, the city’s paramedics will be supplemented by firefighters who would be on duty whether the city had an ambulance service or not.

“We’ve got to look at it that way also to find out what is it really costing the city to have this,” Groves added. “So we just kind of want to make sure we do both ways.”

The city’s Meadville Central Fire Department currently responds to nearly 1,400 medical calls per year, according to Groves, quickly sending two firefighters to the scene and remaining there until an ambulance arrives.

“Two guys,” Groves said, “never got a dime from the ambulance service.”

With an ambulance service of its own, the fire department benefits in two ways: It can receive payment via the patient’s insurance and it can keep two firefighters available for other emergencies at the station.

Under the current model, EMS coordinator Evan Kardosh said after the meeting, two firefighters respond to a medical call using either the department’s pickup truck or a fire engine. If only three firefighters are on duty, that means just one remains at the station. The department’s minimum staffing level is three firefighters per shift.

When the EMS division begins operating next month, an ambulance carrying a paramedic and with a firefighter driving can respond to a medical call, leaving at least two firefighters at the station and available for other calls.

The city is already paying the various costs associated with having the firefighters on staff and operating a fire department. The cost of the paramedic, Kardosh said, will be paid for by the medical billing that results from the EMS calls.

Stand-alone ambulance services that are not part of a fire department can find themselves relying on medical reimbursements to cover the costs associated with multiple crew members throughout the day, Kardosh said, making profitability all the more challenging. The city, in contrast, will only need to generate enough billing to cover the costs associated with one additional staff member at any given time.

“We’re kind of killing two birds with one stone,” Kardosh said. “To pay for that additional cost is a lot more viable option than some of these private services that are trying to pay everything all at once.”

Mike Crowley can be reached at (814) 724-6370 or by email at mcrowley@meadvilletribune.com.

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