FRANKFORT, Ky. (LEX 18) — EMTs from across Kentucky are sounding the alarm about a growing crisis that could leave communities without ambulance services. The problem stems from insurance companies failing to adequately reimburse EMS agencies for their calls, forcing local taxpayers to shoulder the financial burden or local communities to stop ambulance services altogether.
Emergency medical technicians brought their trucks and stretchers to the Capitol Annex on Tuesday urging lawmakers to pass House Bill 447, which would reform ambulance reimbursement in Kentucky.
According to the Kentucky Emergency Response Alliance, insurance companies currently reimburse Kentucky EMS providers only a fraction of their actual costs. The groups says the average cost of an ambulance transport is $1,877, but the average reimbursement from insurance companies is just $635.
This funding gap means taxpayers in many Kentucky counties must cover the difference to keep ambulance services operational.
"Right now, 50, 60, 70, 80% of that (ambulance) bill is being paid by local government taxes offsetting the cost so that the commercial insurance companies can keep more of their money and post higher profits," Jim Duke of the Kentucky Ambulance Providers Association said.
In Fayette County, insurance reimburses only 38.4% of ambulance bills, leaving 61.6 % to the local taxpayers, balance billed to the patient, or left unpaid- jeopardizing ambulance service and EMS staff availability. In some areas of Kentucky, like Laurel County, the reimbursement rate is as low as 9, according to Rep. Rebecca Raymer, the sponsor of HB 447.
The lack of adequate reimbursement has created ambulance deserts in almost 92% of Kentucky counties, according to the Kentucky Emergency Response Alliance. This means residents are more than 25 minutes away from timely emergency medical response.
Areas that have temporarily lost ambulance services, like Lewis County, experienced significant stress during the gap in coverage.
"Our dispatchers were stressed when they answered the phones. Somebody called having a heart attack and they could not promise that they were going to have an ambulance there," Lewis County Judge Executive George Sparks said.
Paramedics say House Bill 447 would require insurance companies to reimburse at the local ground ambulance service rate set by the local governing authority. This change could help keep more ambulance services operational across the state.
Raymer emphasized that many people don't realize the importance of EMS until they need it themselves.
"You don't think about EMS until you are the one on the other side of that phone and you need them to come for you or your family member. And then when you experience that and there's a delay, you're going to understand what an issue this is," Raymer said.
The Kentucky Association of Health Plans voiced concern over the reform effort. According to a spokesperson for the group, the state’s actuaries estimate up to an additional $1.27 per person per month in premiums. For a family of 4, that could be another $60.96 a year in health care premiums. The group says this additional cost could be a concern for working families.
