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Originally Posted by nhboat61
I can understand where you are coming from. My FD runs EMS in Connecticut. We end up writing off 45% of our billing. One of our biggest problems is that we get a good amount of undocumeted aliens and they have no addresses or insurance -so thats a free-bee, we have a high population of elderly. If they are chronically ill and need to have multible trips to the ER, then MA./MC starts to pay at a reduced rate. A portion of the bill is written off.
Running EMS is expensive, being a former fire chief, I know only too well. And yes, the cost of an ambulance is expensive. $190K for the last unit we bought. 5g's for the stretcher, 10K for the defibrillator......that even before you buy a band-aid ( which we have to carry, but can not use). Better stop now before it becomes a ramble.
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Very true for the municipal ambulance such as a city or town that gets their EMS service from their fire department. Not so true for the private ambulance companies, like AMR, that makes their money from non emergency transport and takes their lumps doing 911 contracts, most at "zero bids" in the metro Boston area. The amount of business a private ambulance company gets for transports between medical facilities is not comparable to doing city/town emergency calls. You can't ask a car accident patient or a resident who calls 911 for insurance info, so you do the call and attempt to obtain insurance info at the hospital, many times unsuccessfully. For a non emergency transport you are able to obtain much more patient info and many times the transport is signed off by a doctor declaring the transport a medical necessity and making recoup from their insurance company more likely.
I transported thousands of people from their homes to dialysis appointments, most were regular 3 day a week round trip transports who walked to my ambulance and even sat in the front seat. The reason was their insurance didn't cover a wheelchair van because the van was not considered "medically necessary" as an ambulance was, thus, their insurance covers the ride. Insurance information is obtained before transport. I admit the Medicare/Medicaid patients are not great revenue producers. Running an ambulance company is not easy.
As far as the Mercedes style ambulance. It's a nice vehicle for non emergency transport, but if you are in need of true emergency medical treatment, you don't want that van, the box ambulance is MUCH better for treating the trauma/medical emergency.
The ambulances you see, other than those doing dedicated 911 contracts, are nothing more than glorified taxi cabs. The hourly rate for EMTs and Paramedics are amongst the lowest wages in the medical arena. It's a job with huge turnover, most using it as a stepping stone for more lucrative careers like fire, police and RN's.