A new federal bill backed by a Tarrant County congresswoman could change how local ambulances do business.
The Reimbursing Emergency Services for Critical Urgent Encounter Act, or RESCUE Act, aims to get reimbursement rates for ambulances up to date. The bipartisan bill was co-introduced by Rep. Beth Van Duyne, whose district includes northeast Tarrant County.
The rates were most recently set in 2002 based on data from 1998. A lot has changed since, said Steve Dralle, the president for the south region for Global Medical Response.
“This is the part of healthcare that people say is broken — it’s not the care, it’s the reimbursement model,” he said.
If passed, the bill would require the government to update Medicare rates every three years based on factors including cost data and changes to technology and medical practice.
“Every second matters when an ambulance is racing to save a life — first responders are already stretched thin, and rates that haven’t kept pace with real costs shouldn’t be one more thing standing in their way,” Van Duyne said in a statement posted on social media.
Global Medical Response operates ambulances for the Arlington 911 system in collaboration with the fire department.
Adjustments have been made to rates based on the consumer price index — a measure of how prices urban consumers pay has changed — but those increases are not nearly enough, Dralle said.
The cost of labor more than doubled since the late ’90s, he said. He noted that today’s ambulances use technology and practices that did not exist then, including giving patients blood before they get to the hospital and using heart rate monitors that send hospitals information ahead of arrival.
“Things that we did back then were great, but they are nothing compared to today,” Dralle said.
Roughly 40%-45% of the cost of an ambulance ride the company provides is covered by Medicare. The remainder is taken on by the organization, which manages those gaps by working as efficiently as possible and raising rates across the board.
Medicare patients make up 40% of the company’s ambulance rides in Arlington, Dralle said.
About half of the patients served by the private ambulance company Falck in Tarrant County are on Medicare, said David Phillips, managing director of Falck Southwest, which services regions in Fort Worth, Grand Prairie and other municipalities in Tarrant County.
Locally, the company does sub-911 work, meaning they transport patients from one medical facility to another. Examples include taking patients from nursing homes to the emergency room, or transporting them between hospitals.
Low reimbursement rates for Medicare lead Falck to charge municipalities and health insurance companies more to fill the gaps, Phillips said. It also de-incentivizes ambulance companies from operating in communities that have a high number of Medicare patients, such as Granbury or Stephenville, he added.
If the bill becomes law, it will have an immediate effect on Falck’s business, Phillips said.
“The impact of this isn’t just our ability to get a little bit more financial elbow room, be able to replace equipment and do more training and that kind of stuff, it’s also going to shift resources back toward those Medicare-heavy communities, and that would be a good thing for everybody,” Phillips said.
With better reimbursement, Dralle said Global Medical Response could expand programs or offer more competitive employee pay.
“The better the reimbursement is, the more it’s easier for us to add additional resources as needed to support the community,” he said. “It just provides a lot more flexibility in what we can do.”
McKinnon Rice is the health reporter for the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her at mckinnon.rice@fortworthreport.org.
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