There is no printing press in your payroll department pounding out cash to keep your agency in the black.  The question is where does the money come from to make sure your agency can buy ambulances and supplies and pay employees?

Almost every ambulance company bills for services these days in order to collect the funds from private insurance companies, Medicare and Medicaid.  Many ambulance services also get money from taxpayers in the form of ambulance district and fire department taxes.

The worst funding source of all is Medicaid.

Medicaid is the state operated health insurance program which takes care of the poor, the disabled and others with special needs in Missouri.  Medicaid pays far below the actual cost of transport services provided to these types of patients.

Despite a $1 million Medicaid payment increase, passed by the 2007 Missouri General Assembly, the Medicaid ambulance rates are still profoundly below the industry benchmark provided by the federal Medicare ground ambulance rates – a lot less money for the same services. 

It would currently take a 120% increase in the state Medicaid rates to match the federal Medicare level.  The result is that agencies cannot even break even on Medicaid transports – they actually lose money.  It goes without saying that this erodes the ability of an agency to make ends meet and provide vital services.

According to state law, ambulance services must respond to all requests for transport regardless of the patient’s ability to pay.  Yet the state has neglected to make reasonable Medicaid payment for these services.  This generally results in local governments or hospitals picking up the tab.

The aforementioned $1 million increase in Medicaid funding was a combination of state and federal money that came as a result of the Missouri Ambulance Association and other organizations pressing hard for the change during the General Assembly. 

While the additional funds are certainly appreciated, it will take quite a bit more state money to get the Medicaid payment rates up to the same level as the federal Medicare rates or at least up to a level where money is not being lost by the agencies providing the services.

Preliminary planning for the next legislative session is underway and alliances are being formed to further increase Medicaid funding at the next General Assembly.  Readers are encouraged to contact state legislators now by clicking the link below and emailing messages in support of a new Medicaid increase for ground ambulance providers.

Contact State Legislators

Jason White
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