By Tim Hrenchir
Topeka Capital-Journal (Kansas)
Copyright 2006 The Topeka Capital-Journal
All Rights Reserved
Shawnee County’s ambulance service provider is seeking a significant increase in financial help from the county, saying it receives a much lower local government subsidy than any others among the state’s 10-busiest emergency medical services.
But County Commission Chairman Vic Miller says that before he votes to increase its subsidy, he would like to see American Medical Response ambulance service do more to help itself.
Miller said Wednesday he wouldn’t be inclined to raise the county’s subsidy to AMR until he sees it work more aggressively to recover money from unpaid bills, perhaps by contracting with a local lawyer instead of its current practice of working with two out-of-state collection agencies.
Ken Keller, who oversees AMR’s operations in Shawnee County, said Wednesday that it is often pointless to spend much time and money trying to recover ambulance fees from patients who can’t afford to pay.
“The return versus the time involved is pennies on the dollar, and it’s literally self-defeating,” he said.
Keller was in the audience Monday as County Commissioners Miller, Ted Ensley and Marice Kane rejected AMR’s request that they increase its subsidy to $1,130,494, up 122 percent over this year’s subsidy of $518,957.
Commissioners voted 3-0 to instead subsidize AMR in the same amount next year as for this year.
Later Monday, commissioners approved a 2007 county budget. They have the option when they meet at 9 a.m. today in their county courthouse chambers at 200 S.E. 7th of reconsidering and changing the budget before it is adopted and certified to the county clerk.
But Kane isn’t expected to attend today’s meeting, and Miller said Wednesday he was opposed to increasing the subsidy for AMR, which is under contract to provide ambulance service to Shawnee County through 2011.
Miller suggested AMR could change his mind if it started filing suit against customers who fail to pay.
“I think a better place to get their money is from the people who owe it to them before turning to Shawnee County taxpayers,” he said.
Keller said Wednesday that AMR recovers generally 47 percent of what it bills.
Keller noted that 60 percent of AMR’s customers are covered by Medicare or Medicaid, 21 percent are covered by insurance companies and 19 percent are uninsured.
He said AMR was unable to recover much of what it bills to Medicare and Medicaid recipients because those programs reimburse AMR at a flat rate and AMR is prevented by law from seeking more from the customer than what the program pays. AMR this year began charging patients $629 for ambulance service, up from $562 in 2004 and 2005.
AMR has managed to receive payment of 72 percent of the fees it is legally empowered to recover, Keller said.
He said most of the money that goes unrecovered involves ambulance trips provided to those who can’t afford them.
Keller also said that AMR in Shawnee County recoups 14 percent of the money from accounts it submits to collection agencies when the company is unable to get customers to pay.
Keller said AMR has no choice except to transport patients who can’t afford to pay. He noted that the service made about 265 calls last year to the Topeka Rescue Mission.
“This is not about putting dollars and cents in AMR’s pocket,” he said. “This is about serving the public.”
Keller also provided statistics showing that Shawnee County’s subsidy to AMR amounts to $30.78 per call, by far the lowest among the state’s 10 emergency medical services that make the most calls. At ninth place on that list was Leavenworth County Emergency Medical Service, which was reimbursed at a rate of $88.76 per call.
Miller said Wednesday he was impressed with those facts and other information AMR provided commissioners but — taken in context of all the information he received on the topic — they weren’t enough to persuade him to increase AMR’s subsidy.
“I think they can do a lot more in the way of revenue and until they prove to me that they’re doing it, I’m not willing to give them a handout,” he said.