By Meg Heckman
Concord Monitor
KEARSARGE, N.H. — The growing number of patients without health insurance is taking its toll on the rescue squad that serves Kearsarge-area towns, forcing taxpayers to cover unpaid medical bills and community leaders to reconsider how emergency services are provided.
For the last two decades, New London Hospital has operated the region’s ambulance service and, since 2004, seven nearby towns have subsidized those efforts. The arrangement is unusual but worked until recently. Now, the hospital says it’s bearing a disproportionate share of the cost and is struggling to compensate as the number of uninsured patients rises and government subsidies shrink.
On Monday, hospital officials and leaders from New London, Newbury, Sunapee, Grantham, Springfield, Sutton and Wilmot will meet to discuss the ambulance service. The first step will likely involve hiring a consultant to examine the communities’ options. Hospital President and CEO Bruce King hopes to find a solution that works for taxpayers, patients and health care providers, and he’d like to have it in place by the beginning of 2012.
“We are not abandoning our commitment to emergency services by any means,” King said. “We’re just not sure that (the financial risks of) running an ambulance service should be borne by the hospital alone.”
New London Town Administrator Jessie Levine is hosting the meeting and is eager to hear everyone’s ideas. Options could include hiring a private contractor or operating a traditional municipal ambulance service, perhaps with the hospital’s help.
“This is a friendly conversation,” she said. “We’re all just trying to work together to come up with a solution.”
The hospital’s ambulances made about 1,400 calls between Oct. 1, 2009, and Sept. 30 of this year, which is slightly lower than usual, but the number of patients without insurance grew sharply. Typically, 5 percent of the ambulance’s budget goes toward subsidizing the uninsured. Last year, that number more than doubled, with services for uninsured patients making up 11 percent.
In all, running the ambulance last year cost $900,000. About $600,000 was reimbursed by private insurance companies, Medicare and Medicaid. The seven towns contributed $200,000, and the hospital covered the rest, something that King says made an already bleak budget even worse.
Despite executive pay cuts, wage freezes and changes to employee health insurance and benefits, the hospital was $1 million in the red when its fiscal year ended in September.
“I couldn’t control my payer mix, I couldn’t control that Medicaid reduced its payment,” King said.
He’s not anticipating that things will get any better.
Medicare and Medicaid reimbursements will shrink more next year, and King suspects the number of uninsured patients will continue to rise.
In the short term, the hospital is asking for additional money from many of the towns it serves. Each town’s share is based on the number of times an ambulance is dispatched to the community. New London, Wilmot and Sutton will all see increases, while Newbury’s bill will remain about the same.
New London has been asked to pay $124,000, which is 40 percent more than this year. Wilmot’s share would more than double to $24,700. Sutton would pay 58 percent more, or $37,000.
Copyright 2010 Concord Monitor/Sunday Monitor