HELENA — The Montana Legislature has had a lot of debates this session about Medicaid reimbursement rates for nursing homes and other health care services – with providers saying they need higher rates to account for the costs of those services.
Many ambulance services in the state say they’re struggling with a similar challenge – and they’re willing to charge themselves in hopes of making a difference.
“We’ve had a very thin margin for a number of years now, primarily due to reimbursements,” said Justin Grohs, a paramedic and general manager for Great Falls Emergency Services.
GFES is a private provider that offers paramedic ambulance services across Cascade County, as well as Basic Life Support and other medical transports. They have an all-paid staff, including about 50 full- and part-time EMTs and paramedics.
Grohs says about half of the people they transport are covered by Medicare, and that the federal program reimburses them at a rate close to the actual cost of the service. However, another 20% are covered under Montana’s Medicaid program, which has a lower rate.
“Currently, Medicaid is reimbursing us at below cost – as much as 35 to 40% below our cost,” said Grohs.
Advocates say ambulance providers across the state are dealing with the same type of financial pressure.
“The result is that we've already seen closure of some ambulance services across the state and the threat of closure for more,” said Rep. Ed Buttrey, R-Great Falls, on the House floor Monday.
Buttrey is sponsoring House Bill 828, which passed the House 85-14 Tuesday with bipartisan support. The bill would establish an ambulance provider assessment fee. Each provider would pay 5.75% of their net operating revenues, and the state would use that money as a match to bring in additional federal funding. The extra money would then go back to providers in the form of increased Medicaid payments.
Nearly 80 ambulance services across the state signed on to a letter backing HB 828. Supporters say similar programs have already been established for Montana hospitals. They say the assessment fee would be a way to boost support for ambulances without any need for significant state money. The services could use the money for things like increased wages and upgrading their ambulances and equipment.
Groes said he’s grateful to see strong support for the bill so far. He said GFES isn’t in any danger of closing, but this program would make a big impact on their efforts to recruit and retain employees.
“Personally, that's what I'm probably most excited about, is being able to pay these field personnel better, because the job they're doing is extremely important and they deserve to be as well-paid as possible,” he said.
HB 828 will now move on to the Senate for consideration.