Competition for paramedics and getting Medicare financial reimbursement for services is making the county Emergency Services/Ambulance Department to consider everything from sign-on bonus for …
Competition for paramedics and getting Medicare financial reimbursement for services is making the county Emergency Services/Ambulance Department to consider everything from sign-on bonus for employees to contracting with a private agency to collect from the federal government.
Director Jeremy Peck on Tuesday, Oct. 12 first detailed issues with obtaining a $120,000 payment owed for Ground Emergency Medical Transport (GEMT) services for fiscal year 2020.
Generally, Medicare was to cover 70% of cost and the local service 30%. A further complication is the rates set by the Iowa legislature, which have not kept pace with real costs. As a result, the county is considering a contract between the Washington County Ambulance service and Public Consulting Group (PCG) to negotiate with the federal government and other insurance providers.
“They operate on a contingency basis,” said supervisor Jack Seward, Jr., which means PCG gets paid only if the county does. The contingency fee is 9% of what is collected.
Peck noted that it would mean paying less than $12,000 to get $120,000. Supervisor Marcus Fedler questioned a system that requires providers to pay to get reimbursed for money owed to it.
No vote was taken on the proposed contract, pending further review by the county attorney, who asked for a listing of the insurance companies involved and to also have the supervisors sign the contract as well as the ambulance director. It may be on next week’s agenda.
The more pressing problem is the paramedic shortage, which is a nationwide issue, said Peck, explaining that with hospitals and clinics and private facilities hiring more and more paramedics, the competition for the certified medical personnel has increased tremendously everywhere.
“There are counties offering a sign-on bonus,” he said, explaining that while it is attractive, what happens when the bonus runs out, affecting the pay scale? Even more, what about the effect on current personnel?
“We have to be competitive,” he said, explaining that the department is crediting prior years of experience and service. However, equaling what hospital and clinics pay remains a problem.
He also explained that there is a major difference between being a paramedic in a hospital or clinic where there are regular supervisors “and someone has your back all the time” to being one or maybe two paramedics on a ground crew responding to all kinds of emergencies.
“It takes a different person,” he said of the emergency responders. “We value the people we have and we have to attract more of them.”
In regards to personnel, he asked for and received board approval for classification changes from regular part-time to casual part-time for six EMT personnel: Kasey Wieland, paramedic; Stephen Swaffer, EMT; Joan Sirien, nurse; Bruce Murphy, EMT; Ami Buoi, EMT; and Steven Ebersole, EMT, all effective October 7. Hourly rates remained unchanged.
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