Skip to content Skip to left sidebar Skip to right sidebar Skip to footer

Ambulance service contract deadline approaches

The Unicoi County Commission’s Ambulance Committee is scheduled to meet this week to continue discussing the county’s ambulance service contract. This will be the second meeting in the past week as the committee tries to determine what company will provide ambulance services to the county by an April 1 deadline.
Ambulance services are currently provided by MedicOne Medical Response, which is based in Texas. The company has been the county’s ambulance service provider for the last four years. The contract between the county and MedicOne is set to expire on April 1. It included a yearly subsidy of $180,000 paid to the company by the county all for years.
MedicOne CEO Jim Reeves appeared before the committee during a meeting on Thursday, Jan. 15, at the Unicoi County Courthouse and discussed his company’s history with the county since it was awarded the ambulance service contract, including financial and transport information.
According to Reeves, in recent years the number of transports performed by his company in Unicoi County has decreased. He said that in 2012 MedicOne performed 3,756 transports; 3,587 transports in 2013; and 2,832 transports in 2014. Reeves described this drop in transports as a “red flag” and a “concern.”
“I don’t know exactly why our call volume is down,” he added. “I would like to attribute it to our citizens are getting healthier. I can honestly say it’s two things, in my opinion. I think people are making better healthcare decisions because of the Affordable Care Act and because they’re having to pay more. … Also, I think (Unicoi County Memorial Hospital) is keeping patients. Transport volume out of the hospital is way down.”
Reeves told the committee that each transport performed by MedicOne must generate at least $300 for the company to “break even.” He also said that for his company to run one ambulance 24 hours a day for a full year costs between $450,000 and $500,000.
Reeves also provided the committee with how county residents paid – or did not pay – MedicOne for ambulance services in 2014. He said the payment collection rate for MedicOne in Unicoi County was 32 percent.
“In 2014 we provided a total of $3,062,489.51 in charitable care,” Reeves said. “That is care that is given to patients we didn’t collect, we didn’t bill. It’s charity care. Of that, 33 percent was here in Unicoi County – $1,073,272.18.”
Reeves said less than 40 percent of the county’s “payer mix” in 2014 were insured by Medicare; almost 12 percent were insured by TennCare; 17 percent were insured by commercial insurance; one percent was insured by the Veterans Administration; workman’s comp was one-tenth of one percent; 4 percent were insured by manage care plans; almost 27 percent were self-pay or uninsured.
“I wished people paid the bills,” Reeves said, “but, you can’t squeeze blood from a turnip. … We’re not going to go after people on fixed incomes.”
Reeves also told the committee that since the company began providing service in Unicoi County reimbursements to ambulance companies have been cut.
“Since we have been in this county Tennessee has cut TennCare reimbursements by nine percent,” he added. “The federal government … Medicare was cut 12 percent.”
Reeves did say that the recent decrease in fuel prices has helped the company limit at least some of its costs.
He also said that MedicOne has purchased property on North Main Avenue near Wendy’s in Erwin to build a state-of-the-art ambulance station. However, the construction depends on whether or not the company can renew its contract with the county.
“This will be a station this community can be proud of,” Reeves said.
***
The $180,000 subsidy was a major topic of debate between Reeves and members of the committee.
“I know some folks in the community have an issue with paying a subsidy to a business,” Reeves said. “We’re not a business. We’re a public service agency. You couldn’t expect the sheriff’s department or fire department to operate on revenue generated from their activities – the same with the ambulance service. We do bill for transports, but what we bill in this community does not exceed the cost of providing that service. Sometimes it does. …”
Commissioner Gene Wilson asked Reeves to commit to eliminating the subsidy completely.
“I tell you what, you knock that subsidy off, we’ll give you are five or six year contract,” Wilson said. “We can get this done quick. The county is strapped. You’re saving $180,000 on fuel. Do this county a favor.”
“Honestly, this county can’t make it without some subsidy,” Reeves responded. “Could we do
it for a lower subsidy, we will do our very best. … We’re down almost 1,000 transports from 2013 to 2014.”
Wilson told Reeves he would like for MedicOne to remain in the county.
“Think about this for us,” he said. “We’ll get this thing over with. … We need that zero subsidy.”
Commissioner Marie Rice told Reeves that over the last four years the county has paid MedicOne $720,000 for the yearly subsidy.
“That’s quite a bit of money for a county of our size to put out,” she added.
Reeves then told the committee that MedicOne would agree to lower the subsidy to $120,000, but no lower.
“I want to make this work,” he added, “but, it’s a matter of economics. … This county does not have enough income from he calls to cover the cost of running the service.”
“I’ll guess we’ll just have to bid it out,” Wilson said.
Rice also told Reeves that she believed an ambulance service in the county should earn a profit of $1.5 million to $2.5 million based on models.
“There’s no profit,” Reeves said. “This county does not even generate close to that in overall revenue.”
Wilson asked if MedicOne was “running on 22 percent profit.”
“Are we running on 22 percent profit?” Reeves responded. “If I was running on 22 percent profit I wouldn’t be standing here. … If you’re doing three percent profit margins (in this industry) you’re doing good. We’re not even doing that. You guys are playing off a sheet of music that isn’t even reality.”
The meeting then adjourned.
This week’s meeting of the Unicoi County Ambulance Committee has been scheduled for Thursday, Jan. 22, at 3 p.m. at the courthouse.