Non-transport EMS billing a necessary step

Published 12:07 am Wednesday, July 3, 2019


The Advocate-Messenger

It’s a new fiscal year and Boyle County EMS has begun a new practice of billing for runs that don’t result in transporting a patient to the hospital.

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The agency is now approved to bill up to $375 for “ambulance response treatment, no transport.”

Previously, if someone needed help such as assistance getting up after a fall or just someone to get them some food during a diabetic emergency, Boyle EMS personnel would mount up, head out, provide help and head back to base, all without any compensation.

It’s nice to think about trained medical professionals helping those in need and not asking anything in return. But as everyone ought to be aware, there is no free lunch. Those non-transport runs only looked free because the price tag was hidden — it was being covered by Boyle County taxpayers.

The county’s general fund is expected to subsidize EMS service to the tune of around $1 million this new fiscal year — and that’s with some added revenue from non-transport billing and some other fee and rate changes.

That’s not to say EMS should be self-sufficient, entirely funded by fees charged to patients. Such an arrangement would make ambulance rides even more cost-prohibitive than they are now, excluding many if not most Boyle Countians from access to an essential health service.

There is a balance to strike between public and private funding for EMS service, and this new charge for non-transport runs strikes the balance quite nicely.

Before, if you were in need of serious medical attention, you had to chip in a good chunk of the cost required to get that attention. If you only needed a little medical help, however, taxpayers were expected to write the check. When around one in five runs is non-transport, that winds up being quite a big check.

Now, everyone who needs Boyle EMS for any level of care will be expected to help pay for that care. It’s a much fairer system for everyone involved.

Some are concerned that the new billing will be disproportionately painful for poorer Boyle County residents. That concern is good — any time you talk about a change to something as vital as EMS service, you should be keeping an eye on how the most vulnerable in the community will be affected.

In this case, we think the benefit to the overall health and sustainability of the EMS department outweighs the potential that some impoverished residents won’t be able to afford a bill for non-transport services.

It’s already the case that those same residents would also be unable to afford an actual ambulance transport, but no one is planning to do away with billing for transport runs. And if EMS Director Mike Rogers is correct, government-funded health insurance programs like Medicare and Medicaid will soon begin paying for non-transport runs, meaning a large number of Boyle County’s poorest and elderly residents will be covered should they need non-transport assistance.

We don’t live in a perfect world and there can be no perfect solutions. It won’t surprise us if there are some anecdotal cases where non-transport billing creates problems for some individuals. But we think on the whole it will end up being a net positive for the community, because the county will be able to continue providing an exceedingly high level of EMS care in a fiscally responsible way.