American Medical Response, Spokane’s ambulance service provider, could soon be allowed to increase the rates it charges Spokane patients by more than 20%.
Spokane public safety officials are pushing the city to approve a one-year contract extension with the private ambulance company that would increase its rates from a base of $757.39 to about $975, although the exact amount has yet to be determined.
Fire department officials are pushing for the new contract even though the city could lock in a five-year contract renewal, finalized when the current deal was approved, that would raise the rates by only 2%.
The company, officials argue, has historically charged Spokane lower rates than other communities, but is now facing increased labor costs and the burden of providing ambulance service during the COVID-19 pandemic.
“We’re just doing what we can to keep the service solvent,” Spokane Fire Chief Brian Schaeffer explained to the City Council’s Public Safety and Community Health Committee on Monday.
Although the Spokane Fire Department provides emergency medical services, the city contracts with AMR as a medical transportation provider.
The company’s contract expires in June, and the city has an option to extend it for another term of five years. Instead, the Spokane Fire Department is proposing just a one-year contract extension that acknowledges the changes brought on by COVID-19.
Those adjustments include more rigorous cleanings of equipment and the loss of staff who needed to be isolated. While many of the “trigger points” haven’t yet been hit, Schaeffer said the new contract would allow AMR flexibility if a second wave of the virus hits Spokane.
Call volume has not increased since the pandemic started, but AMR could see an increase in patients if COVID-19 spreads.
Under the proposed one-year deal, AMR would be allowed to charge an increased rate for its service. If the city renewed the five-year agreement with AMR, the company would see about a 2% increase in its rates. Under the one-year proposal, the company could charge more. Although the exact amount has yet to be determined, it could be about a 28% jump.
Councilman Michael Cathcart told The Spokesman-Review he wonders if AMR is the only viable option.
“I would be more interested in going out and seeing what sort of bids there are and what alternatives exist,” Cathcart said. “You want to make sure you’re getting the most efficient and effective ambulance service you possibly can.”
Council President Breean Beggs said he was also skeptical of the proposal.
“Those are rates that our community members pay and insurance companies pay, so I would like to talk with our community members and insurance companies – and also the workers at AMR,” Beggs said.
The city also would allow AMR to compensate for the reduced number of available paramedics with less-skilled EMTs and waive penalties charged to AMR for longer response times if their vehicles are out of service to allow for decontamination.
“The reason for that, as we’re seeing across the country, is the amount of (decontamination) that needs to occur after a patient is transported. … Right now, all of our patients we’re assuming are COVID-positive until proven otherwise,” Schaeffer said.
But the new contract also would call on AMR to respond to non-urgent medical calls without the assistance of the Spokane Fire Department, in an effort to conserve the latter’s resources during the pandemic.
In justifying the rate increase, Spokane officials compared Spokane’s rates with other communities in the Pacific Northwest in April. The company charges a far lower base rate for basic life support and advanced life support services in Spokane than Tacoma or Seattle.
City officials note that about 75% of people who use the ambulance service in Spokane are covered by Medicare or Medicaid, and thus would not be directly impacted by the rate increase. The rest are typically covered by private insurance companies, who negotiate with AMR directly.
“We want to make sure that out-of-pocket expense on the people in our community (who) are most vulnerable is very minimal,” said Mike Lopez, integrated medical services manager for the Spokane Fire Department.
The proposed contract was discussed by the City Council’s Public Safety and Community Health Committee on Monday, but no decisions were made.
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