Cost of Ambulance Transports for Low-Volume Providers in Rural Areas and Its Implications for Medicare Reimbursement Policy
Ambulance providers that serve sparsely-populated rural communities face unique challenges in covering their costs of service because the average cost of an emergency transport is higher, all other things being equal, for a low-volume provider than for a high-volume provider. The purpose of this project is to explore the basis for a payment differential for low-volume rural ambulance providers and to make policy recommendations regarding Medicare payment to ensure that fee schedule design does not compromise access to ambulance transport services in sparsely-populated rural areas. This project uses data from the National Survey of Ambulance Providers, a nationally-representative survey of firms that bill Medicare for ambulance transports, to estimate the average costs of providing different levels of ground ambulance services. Both descriptive and multivariate analyses of these data are ongoing. Our policy recommendations will be based on the mix of volunteer and full cost providers in rural areas and other literature showing trends that are occurring to change this mix. We also we address the role that the Medicare Rural Hospital Flexibility Program may play in ensuring fair compensation of rural ambulance transport providers.
Publications
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Establishing a Fair Medicare Reimbursement for Low-Volume Rural Ambulance Providers
Author(s): Penny E. Mohr, C. Michael Cheng, Curt D. Mueller
Date: 07 / 2001
National study of ambulance transport costs looks at the advantages and disadvantages of several options for Medicare to compensate low-volume rural ambulance providers. Among its conclusions: many low-volume rural volunteer EMS providers will benefit from the new Medicare fee schedule; a volume-based premium offers a disincentive for small providers to grow and take advantage of economies of scale; and cost-based reimbursement for a select class of rural providers would not over- or under-pay vulnerable providers. Report available on request.
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