Woodburn Independent Online

Woodburn Ambulance hit hard with budget cuts

11 percent decrease has the local business pinching pennies

• By: Jason Horton  
• Published: 1/8/2010 6:31:44 PM

WOODBURN — Woodburn Ambulance is looking at an 11 percent decrease in Medicaid reimbursements and that could have a long-term impact on the services provided to the Willamette Valley.
 
“The immediate impacts are going to be delays in equipment replacement, postponing any kind of upgrades to newer drugs that are expensive to carry until we can get this addressed by Congress somehow,” said Shawn Baird, co-owner of Woodburn Ambulance. “The biggest thing is personnel. … Our paramedics have been very good at staying and working despite not being able to keep up with wages.”
 
The cuts stem from Congress giving less money to rural ambulance services in order to give a static amount across the board, whether servicing rural or urban areas.
 
Woodburn Ambulance gets a majority of its budget from Medicaid and Medicare reimbursements (65 percent from Medicaid alone). Baird said Congress has been steadily cutting reimbursements of Medicaid.
 
“Congress decided to pay all ambulance services the same regardless of where they were located and places that were rural, like us, were paid a little more, because it takes a little longer per call than in urban areas,” he said. “When they decided to go with one rate for everybody, our rates dropped dramatically and other parts of the country (urban areas) were raised.”
 
The 11 percent cut will translate to roughly $150,000.
 
“The cuts affect all of Oregon and some areas took an even steeper cut. The extremely rural areas were cut 26 percent,” Baird said.
 
“I’m crying that we got cut 11 percent, but frankly, the doors would shut if we got cut 26 percent.”
 
Less money puts services like Woodburn Ambulance in a catch-22. Their operating costs are the same, yet their reimbursements are being cut and on top of that, they can’t bill out to the largest group of patients they serve.
 
“We’re not allowed to bill Medicaid or Medicare patients. We have to accept what they pay as paid in full,” Baird said.
 
“We have to accept what the federal and state governments pay us, regardless of what it costs us.”
 
Despite making the cuts, Baird said Congress knows rural ambulances services are more expensive.
 
“Congress did a study of what it costs for a service in our area does and we are underfunded by 17 percent and that was before this cut,” he said.
 
Those costs will be transferred to the private sector, he said.
 
“The only resource we have is to cost-shift it to the privately-insured. … That’s about 15 percent of our calls and they are making up all of that difference from the underpayment from the state and federal programs.”
 
However, despite the cuts, Baird said patients will not see a drop in quality of service.
 
“We are not changing the number of ambulances in service, where they are deployed and how quickly they get out the door,” he said. “Most things will be invisible to the public as to how we absorb this, but not to us.”
 
Woodburn Ambulance also does not get tax support.
 
“We’re a small independent business and everything we do is paid for by patient fees,” Baird said.
 
So what changes can be made to get the federal government to cover the cost of the service provided?
 
Baird serves on the board of directors for the American Ambulance Association and serves as president of the Oregon Ambulance Association, which is part of the former.
 
“The real answer is we have to get Congress to recognize that Emergency Medical Services is a critical function in our community and needs to be reimbursed at least at cost of Medicare and Medicaid patients,” he said.
 
“Everyone gets state-of-the-art emergency medical services when they call 9-1-1 within minutes. The problem is, that access is not really being paid for and we’ve tried to shift (money) for a few years and eat the loss on people who don’t have insurance. ...
 
“I think Congress and the state legislature need to wake up and realize down the road, (Congress) at least needs to cover the cost of the job, or we will get into a place where we won’t have the resources to make the response times people expect right now.
 
“That would be a sad day. And it would undoubtedly be a cost in lives and suffering, no question.”

  (log in to rate)