Friday, November 4, 2011

Ambulance providers could lose funding

Potential drop in revenue raises concerns

Express Staff Writer

A Wood River Fire & Rescue ambulance is driven through Hailey on Tuesday. Though stressed ambulance providers could be slightly relieved by St. Luke’s providing transfers between the hospital and facilities in Boise and Twin, Ambulance District commissioners said Tuesday they worry about revenue lost from patient billing. Photo by David N. Seelig

The Blaine County Ambulance District continued to hash out a contract with ambulance providers this week, but discussions were stalled over concerns about how much revenue the departments could lose along with interfacility transfers.

Interfacility transfers occur when patients needing a higher level of care are moved from St. Luke's Wood River Medical Center to Boise, Twin Falls or Salt Lake City for care. Patients are billed for this service, and until this month, payments were made to the Ambulance District for transfers made by the Ketchum Fire Department and Wood River Fire & Rescue.

During an Ambulance District meeting Tuesday, Commissioner Larry Schoen said the district could lose up to $100,000 in revenue due to lost billing from interfacility transfers that since Nov. 1 are being provided by the Air St. Luke's ambulance service. The hospital decided to take over the service rather than provide additional money requested by Ketchum Fire and Wood River Fire & Rescue.

"We're looking at a loss to the Ambulance District," Schoen said. "If the Ambulance District is losing revenue, that puts a ding in our reserves."

Schoen suggested reducing contract amounts with Ketchum Fire and Wood River Fire & Rescue, which still provide emergency ambulance service for patients transported to St. Luke's Wood River Medical Center. Schoen said that since the district is losing revenue from the loss of the transfers, a 3 percent increase in the district's $2.2 million budget might not be necessary.

However. Ketchum Fire Chief Mike Elle and Wood River Fire & Rescue Chief Bart Lassman said the exact revenue loss is difficult to determine, and the department will likely need the full proposed amount to continue operations.

"We believe we are still going to be asked to do transfers," he said. "We don't think the hospital is going to be able to handle the entire load, and they will call on us. We need the money to operate."

"It would be better not to change the budget," Elle added.

The exact amount of lost revenue from these lost transfers is unclear, however.

The county contracts with a medical billing service that does not have an easy way to separate bills for interfacility transfers from bills for other ambulance services.

"We can do it, but it will be crazy," Lassman said, and will require a great deal of time.

County Medical Director Keith Sivertson said another complicating factor is that many bills from the previous fiscal year are not processed until the next fiscal year. The district will still receive revenue from interfacility transfers well into 2012.

The commissioners agreed to delay approving a final contract until the billing services firm could be contacted and provide a more thorough breakdown of how much revenue the departments previously gained from interfacility transfers.

The breakdown is expected before the end of January.

However, Bowman said he would prefer not to change the contracted amount.

"I trust that the providers are responsible," he said. "[They know that] you can take more now, but you'll have less later."

Lassman agreed, and said the county should wait to change the budget until it's clear how many transfers the department actually loses.

"We're going to continue to do some, so we'll see some continued money to come into the county," he said. "In the end, we may see a net loss. But don't punish us yet."

Katherine Wutz:

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