GFES requesting rate increase for ambulance services

Great Falls Emergency Services is increasing a rate increase for ambulance services.

Under state law and city code, GFES is required to submit a proposed ambulance fee schedule to the EMS administrator, which is the city, for consideration by the City Commission.

The fees need to be consistent with industry best practices, the market and applicable federal and state laws, according to the city staff report.

During the June 2 meeting, City Commissioners will consider the request on first reading and set a public hearing on the proposed rate increase for June 16.

On April 1, GFES Manager Justin Grohs notified the city that GFES was seeking a rate increase.

The last increase was in 2014 and the annual western consumer price index doesn’t keep up with rising costs of providing emergency healthcare, according to Grohs letter.

GFES used The Abaris Group, a consulting firm, to generate the rate increases.

“This rate increase will help subsidize additional staffing that GFES has put on over the last few months,” Grohs wrote. “It is worth noting that this rate increase will affect only about 12 percent of all transports, since most of our transports are billed to fixed-rate government payors such as Medicare. In other words, this increase will, as usual, affect only a small percentage of the population in Great Falls.”

In a March 31 letter, Mike Williams, Abaris president, sent requested information about a rate increase to Dave Kuhn, GFES president.

Williams worked with the city years ago in developing the current response time performance standards and the implementation of the current ambulance service standard in the city.

“We have evaluated ambulance rates currently charged by GFES in Great Falls and other similar rates provided in small cities across the county. We also noted that GFES has not had a rate increase in several years aside from the annual CPI increase permitted by the contact. This annual CPI increase does not meet the escalating costs of healthcare services,” Williams wrote. “We also studied other ambulance rates in Montana when they were available; they also strongly suggest a rate increase. The proposed GFES rates are below the rates of most comparable Montana EMS services. Comparable communities in California and Arizona have Advanced Life Support base rates of $3,000 to $4,000 with adjustments for Basic Life Support at the same levels. The challenges in ambulance rates are increasing costs, the addition of state and local mandate and shrinking reimbursement especially from Medicare. This is a universal concern amongst ambulance services in the country especially in suburban and rural areas where there are smaller number of EMS calls to recover these costs and revenue shortages.”

The City Commission approved an agreement with GFES for citywide emergency ambulance services in 2008.

An increase in ambulance rates would have no impact on the city’s general fund.

City staff has reviewed information provided by GFES and based on that information, “it appears a rate adjustment is necessary to ensure the financial stability and vitality of Great Falls Emergency Services business operations. It must be noted due to confidentiality of many of the private ambulance providers’ rate structures, it is difficult for staff to verify all of the data provided by GFES,” according to the staff report.

In the agenda report, staff indicate that Grohs told staff the increase is needed to “offset a portion of the estimated additional ambulance variable cost of $295,000 a year.”

The city hasn’t mandated changes to the deployment model and staffing requirements of the current ambulance services agreement, which was agreed upon by both the city and GFES, according to the staff report.

In their documents, GFES states that Missoula Emergency Services pays the city fees about half the amount that GFES pays the City of Great Falls.

According to Great Falls staff, Missoula Emergency Services pays the city fees of $10,000 for contract oversight, $24,000 for first response fee and $10,000 for medical director services. MES and the Missoula Fire Department do not pay dispatch fees to Missoula County’s dispatch center.

“In Great Falls, GFES pays $29,878 for dispatch services in comparison to $468,000 GFFR pays for dispatch services. This cost for dispatch services is the difference in fees paid between GFES and MES,” according to staff.