City ambulance services navigate changing medical times

  • Article by: Mary Jane Smetanka , Star Tribune
  • Updated: January 5, 2014 - 5:20 PM

Even as more people dial 911 for help, payment is dropping.

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jbpaperJan. 5, 1412:02 AM

"Ambulance services that charge $1,400 for an emergency trip usually are reimbursed $425 or $450 by Medicare or Medicaid, he said."----- Those number mean nothing without knowing what theirs costs are. If their costs are under $425 they are still coming out ahead especially if you factor in the times are getting more than that. They could even lose money on some runs and come out ahead if they make enough on other runs.

Places often price services/products high knowing that insurance companies/gov't/consumers are going to offer to pay a lower rate. Certain people (insurance co/medicare) have more leverage than most people giving them even more power to set the rates.

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stillonlymeJan. 5, 1412:20 AM

It seems like I've heard of some other city around here. Edina ... St. Paul ... Burnsville ... Lakeville ... huh. Wonder what it is.

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arspartzJan. 5, 14 2:39 AM

The biggest problem is, once again, EMTALA. If someone calls 911 for a "ride to the hospital for the flu," the service is required to provide the service even if the MC/MA claim is later denied for being medically unnecessary.

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localguyJan. 5, 14 7:58 AM

An ambulance service is only as good as the crew. A few years ago, my wife called 911 because I'd collapsed. The EMTs concluded that I was drunk. They didn't think that a trip to the hospital was necessary, but my wife (who has no medical training) disagreed. My wife was right. I wasn't drunk. I was having a stroke and could have died. You really have to be an advocate for yourself and your loved ones. You have a lot more at stake then the professionals do.

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mn2niceJan. 5, 14 8:17 AM

arspartz, so what would you have agencies do, refuse transport for a not immediately life threatening illness or injury? Or are we going to stoop as low as to request prior authorization from insurance providers for transports which are not life threatening?

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jurburJan. 5, 14 9:14 AM

Paramedics are not nurses. They do not have the educational background nor the license to practice community health nursing. EMT training consists of a vocational/technical certificate and degree programs that focus on emergency care in the field and treating abnormal cardiac responses. There is no such thing as a "community paramedic." Paramedics lobbied the legislature hard to allow them to go into people's homes on their down time to increase department revenu and perform nursing duties for which they are not trained such as: managing chronic diseases, medication reconciliation and teaching, case management, wound care, administrating immunizations, preventative care, and health education. Paramedics have aggressively been rustling up business for themselves hounding public health and home care agencies to tag along and learn the ropes from experienced nurses. Paramedics who go into homes to perform nursing duties are practicing outside the scope of their education and their EMT certificate/diploma/degree. This is a violation of Minnesota's Nurse Practice Act. They, their city, and their city departments are liable for any injury that may occur to the individual that they are practicing nursing on. If sued for malpractice, these individuals and their associations would have a very hard time defending themselves.

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dwp4401Jan. 5, 1410:30 AM

jurbur's above comment made this career paramedic chuckle. Back in the day nurses fought tooth and nail against Emergency Medical Services using the same arguments that jurbur is using today.

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horsefeatherJan. 5, 1411:19 AM

Keep a computerized list of those people that don't pay for the services...and when they call don't go get them! There is nothing in the U.S. Constitution that guarantees you will be picked up by an ambulance when you call 911. There is nothing in the Constitution that guarantees you health care! Run the ambulance service just like a business.... if you can't pay the bill then you don't get the service! Go ahead...go to a gas station in Minneapolis and tell them you are NOT going to prepay or even pay for the gas...but you still want it...see how far that gets you! Health care or Health services are NOT guaranteed in the Constitution! We Republicans ARE taking back our America in 2014 n 2016...and we will take back all these health care regulations too!

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jurburJan. 5, 14 6:07 PM

The Lady with the Lamp started the first nursing school in 1860. The first paramedics were trained in 1967 and they did not staff ambulances until after 1970. Paramedics started to use evidence based medicine after the 1990, 130 years after the first nursing school began. Contary to the paramedic post, paramedics did not exist before nurses. As a matter of fact, they are still trying to figure out what to call themselves. Training for a paramedics range from 6 months to 4 years. The National Highway Traffic Safety Administration designs and specifies the training criteria for paramedics. Paramedics follow standing orders for emergency response treatments that are developed by physicians and nurses. Again they are not nurses. If they want to become a nurse then they can spend the money and time to get the nursing education and licensure. In the meantime, lets make sure paramedics don't pretend to be nurses and treat people that they are not trained to treat.

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arspartzJan. 6, 1411:51 PM

so what would you have agencies do, refuse transport for a not immediately life threatening illness or injury?

Yes. The Big "E" in EMS and ER stands for "Emergency." Using an ambulance for a simple ride to the ER (the only place an ambulance can take a 911 call) is as wasteful as going to the ER for non-emergent care.

Or are we going to stoop as low as to request prior authorization from insurance providers for transports which are not life threatening?

This actually does occur when someone wants to get transferred from hospital to hospital for their choice rather than specialty care

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