Pa. EMS providers seek higher reimbursements for services
Low reimbursement from government and private health insurers have put many of Pennsylvania's ambulance companies in a financial vise
By David Bruce
Erie Times-News, Pa.
Northwestern Pennsylvania's emergency medical service organizations have to compete with convenience stores, supermarkets and fast-food restaurants for new emergency medical technicians.
The pay for entry-level EMTs, who provide immediate medical care to people and transport them to hospitals, is less than $11 an hour.
"Places like Sheetz and Aldi pay their entry-level employees more for than we do," said Eric Henry, owner of Meadville Area Ambulance. "It makes it extremely difficult to recruit and retain good EMTs and paramedics."
Low reimbursement from government and private health insurers, coupled with state laws that prevent EMS organizations from charging patients they treat but don't transport, have put many of Pennsylvania's ambulance companies in a financial vise.
They can't pay their EMTs and paramedics, who initially earn about $13 an hour, enough money to prevent them from leaving to take other jobs. Many of them take the job on a temporary basis, said Bill Hagerty, executive director of EmergyCare.
"We get a fair amount of employees who are nursing students or medical school students who are using EMS as a stepping stone," Hagerty said. "They are great employees but it leads to a high turnover rate."
EmergyCare employs about 200 people, 20 fewer than what it needs to run its operations. As a result, Hagerty and other administrators who are EMTs or paramedics are going out on calls at least one shift per week.
Pay increases are in the future, however. Medicare, the health insurer for about one-quarter of all EmergyCare calls, will increase its reimbursement by 50 percent starting Jan. 1, Hagerty said.
"This will help but even with the increase it will still cost more for us to make a run than what we receive in reimbursement," Hagerty said.
EMS organizations hope that legislation being considered in the state House and Senate will remedy the situation.
Pennsylvania law prohibits them from charging a patient who receives treatment at the scene but refuses transportation to a hospital. The two similar bills under consideration would allow the companies to charge for any medical care they provide.
"Our bill was passed over to the Senate," said state Rep. Parke Wentling, R-17th Dist., of Mercer County, whose district includes western Erie and western Crawford counties. "It has tremendous support. This is a very important service, actually a requirement for municipalities to have these services."
These payments are needed, especially in rural areas where EMS organizations are assuming larger coverage areas because of the closing of some volunteer ambulance companies due to lower reimbursements and recruiting difficulties.
Meadville Area Ambulance now covers Cambridge Springs and Cochranton in addition to its traditional area, Henry said.
"It not only forces us to cover more territory, we used to hire some of our EMTs and paramedics from the volunteer companies," Henry said.
If reimbursements don't improve, EMS organizations will have to make more difficult choices, like when EmergyCare sold its LifeStar medical helicopter program. The service has been operated by STAT MedEvac out of Pittsburgh.
"We will continue to have problems with recruitment and retention if reimbursements don't improve," Hagerty said. "We are trying different things, like training people ourselves, but higher reimbursements are key."
(c)2018 the Erie Times-News (Erie, Pa.)