Ambulance services sound calls of alarm

Ambulance companies exist to help those in dire need of medical attention.

Now, they’re in dire need of a financial remedy. And with the number of local ambulance companies down to 17 — compared to 36 two decades ago — and Lancaster County’s population expanding, we need lawmakers and county residents to heed this alarm.

As LNP reported Wednesday, the largest ambulance service in the county — the nonprofit Lancaster EMS — wrote off $1.6 million in unpaid bills in 2016.

It has sought to recover that money from fees, but has only managed to collect 52 percent of what it’s owed. Something has to give. Dean Bollendorf, president of the Ambulance Association of Pennsylvania, told LNP that there are “some emergency ambulance services that won’t be here in the next six months.”

Access to ambulance services isn’t a frill — it’s a lifesaving essential, as anyone who’s ever had to summon an ambulance knows. So what to do? It’s going to take time to see any abatement in the heroin epidemic, so ambulance companies can expect to have to continue buying Narcan — the overdose antidote — in great quantities.

It would help if pharmaceutical companies stopped raising the price of that vital antidote.

But that would only be a partial solution to the financial woes of local ambulance companies.

Some of them have chosen to merge, which has enabled them to pool resources to buy expensive equipment (a single ambulance can cost around $150,000).

But the greater problem lays in the federal Medicaid reimbursement rates, which haven’t increased since 2004.

An average call costs Lancaster EMS $350, but it is reimbursed only $200 by Medicaid.

Additionally, some insurance plans have high-deductibles for ambulance service.

So someone will use the service, get a bill for the cost of the deductible, and simply choose not to pay it.

And then there’s the lack of compensation when a call doesn’t result in hospitalization.

“If we go to assist someone, let’s say if they fell out of bed or they need assistance in some way and we don’t take them to the hospital, we don’t get paid,” Lancaster EMS executive director Bob May told LNP.

This is a complicated issue that isn’t going to be resolved easily.

We’d like to see our local state lawmakers consider how the state Legislature might act to offer relief to ambulance companies.

We’d also urge the Lancaster County commissioners to consider dedicating funds to emergency services.

Lancaster County Commissioner Josh Parsons noted in an email that the county does provide logistical support through the Lancaster County Public Safety Training Center.

He said he’s been spending time “meeting with fire service and EMS groups to better understand their challenges.”

There are “ongoing discussions in the community” about what the future holds for both EMS and fire companies, and “what direction is best to ensure sustainability,” Parsons said.

We’re glad these discussions are taking place. We just hope they lead to some sort of tangible results.

In the U.S. Senate, a bill — S.967 — seeks to amend the Social Security Act to increase access to ambulance services under the Medicare program and to reform payments for such services.

It’s been referred to the Senate Finance Committee, on which our own Republican Sen. Pat Toomey and Democratic Sen. Bob Casey Jr. serve.

If they, or their staff members, haven’t yet read the LNP/LancasterOnline story about the plight of ambulance companies here, we’d urge them to do so.

It makes for unsettling, but important, reading.

Imagine calling for an ambulance and having no one respond.

That’s likely how those in charge of our struggling ambulance companies feel now.