Image courtesy of premierambulance
A new financial study of three dozen emergency providers, prompted by House Bill 1322, reveals that North Dakota ambulance services are losing about $500 on every transport, and this deficit is what local leaders are warning is a “new normal” for emergency response in the state, according to the North Dakota Monitor.
The findings were presented Wednesday to the Legislature’s interim Emergency Response Services Committee, and they show that average revenues remain stagnant at $1,100 per transport, while the average cost per transport has risen to $1,600. Ambulance services must make up for this with tax subsidies, community fundraisers, or by offering contract services.
74% of ambulance expenses go toward staff salaries, but their wages still remain low compared to other emergency sectors, according to the Monitor. Equipment costs add up; a new ambulance can almost cost double what they did pre-pandemic.
State Representative Todd Porter (R-Mandan), owner of Metro-Area Ambulance Service which serves Morton and Burleigh counties, pointed to federal Medicare rates as a primary culprit. In the Bismarck-Mandan area, Medicare patients make up 60% of calls, yet Medicare reimburses at significantly lower rates than private insurance. About 17% of ambulance calls result in treatment at the scene without transport, for which Medicare provides zero reimbursement. Porter told the Monitor that “This is a federal government problem. This is a CMS (Centers for Medicare and Medicaid Services) problem that we’ve known about for years.”
Patients struggle to pay for ambulance bills: the survey found that about 2,300 of the nearly 33,600 patient transports billed last year ended up in collections, totaling about $2.7 million. Including other providers not surveyed, estimates place this number closer to $6 million. The committee intends to take a deeper look and will possibly address the issue in the 2027 legislative session.
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