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Hall wants bigger EMS fee hike
Commissioners approved increase of $125 last year
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The Hall County Board of Commissioners is looking at raising Hall County EMS ambulance fees once again at this evening’s commission meeting.

Hall County Fire Services Chief David Kimbrell proposed a 10 percent increase on ambulance fees at a Tuesday commission work session. Instead, commissioners asked the chief to present other options that would raise the rates even higher as they look ahead to potential shortfalls in the upcoming budget year.

“Why don’t you see about another number up there and come back and share it with these commissioners?” said Chairman Tom Oliver to the fire chief.

County officials say the burden of any hikes will largely fall on insurance companies rather than directly on taxpayers, and it could help the county reduce the gap between the operational budget of EMS and the amount collected in fees.

“This, I don’t think is a profit center for us,” said Commissioner Craig Lutz at Tuesday’s meeting.

The budget for Hall County EMS is estimated at $7.3 million dollars. In the current fiscal year, the department expects to bill about $3.5 million, still leaving more than half of its expenses to be made up through the county’s general fund.

Still those collection estimates are significantly higher than from previous years because of a recent hike in ambulance fees. Traditionally, Hall County EMS fees were actually much lower than surrounding areas and were set at the rate of Medicare allowance.

In the 2010-2011 fiscal year, the county’s standard emergency transport fee was $400. That rate was raised to $525 this year.

For the upcoming fiscal year, Kimbrell had proposed a modest increase to $575. He estimated that the median rate in surrounding counties is about $587.

However, Commissioner Scott Gibbs asked about the higher rate in Gwinnett County, which is $995.

“I’d like to see us a little more in line with that,” he said.

At whatever levels the county decides to set ambulance rates, collection of that money is not quite simple math.
Kimbrell estimated that with the 2013 rate he proposed, the county would collect only about 60 percent of what it bills.

Much of what’s collected in ambulance transports is tied to what is allowable from Medicare and Medicaid.

For standard emergency transport calls, Medicare sets its allowable payment at $414.31, short of the current and proposed rates.

Kimbrell estimates that more than 41 percent of billable EMS services are to Medicare patients, 5 percent are in Medicaid  and 36 percent are private insurance. Roughly 7 percent are from private payers whose bills are considered noncollectable. With Medicare and Medicaid fixed and many uninsured unable to pay, officials say that leaves the rest of ambulance fee hikes to be sent to insurance companies.

Depending on the insurance plan, that cost could still end up going to patients.

During their discussion of other counties’ rates, commissioners also said they wanted to look at fees charged in Forsyth County, which uses a private ambulance service.

Oliver made that request with a disclaimer.

“I have no desire to privatize,” Oliver said.

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