Northwest Emergency Medical Services is facing serious financial problems caused by multiple factors, including the opioid crisis and problems with getting payment from health insurance companies.
Scott Kingsboro, executive director of the nonprofit ambulance company, said in an interview that opioid overdoses affect many types of people. He said about half of the calls for opioid overdoes come from people with health insurance.
“It doesn’t have any economic bounds,” Kingsboro said.
But for people with private insurance, a big problem is that the insurance company sends a check to the patient, rather than to the ambulance company. Kingsboro said the check might come in a thick envelope with the insurance company’s explanation of benefits and the patient might not bother reading through all the paper inside and might not see the check. Or in some cases, the patient does get the check, but cashes or deposits it and keeps the money.
Kingsboro said it is possible to get the insurance companies to pay the ambulance company, but that means accepting a much lower rate – often half or even onequarter of the amount the insurance company would send to the patient.
“You lose so much, you’re better off trying to get the checks,” Kingsboro said.
In addition, some people in need of ambulance services have no insurance, or insurance that does not cover ambulances.
“We don’t worry about whether a person has insurance,” Kingsboro said.
Medicaid, the government insurance program for the poor, will increase what it pays ambulance companies starting on Jan. 1, 2019, but that will not help Northwest EMS much because only about 1 percent to 2 percent of its patients are on Medicaid. Ambulance companies serving Harrisburg and Lancaster City should benefit more from that, Kingsboro said.
“We’ll get some, don’t get me wrong, but it’s not going to be a significant blip in the radar,” Kingsboro said.
The public can help Northwest EMS by purchasing memberships. Solicitations for memberships go out each year at the end of November. When nonmembers need ambulance service, they are billed for the difference between what their health insurer pays and the cost of the ambulance call; members do not get billed for this.
Kingsboro said it costs a lot to keep people ready at the four stations, which are in Elizabethtown, Manheim, Maytown and Brickerville. Its primary response area includes at least part of eight townships and three boroughs in Lancaster County (the boroughs of Elizabethtown, Manheim and Marietta and the townships of Clay, Conoy, East Donegal, West Donegal, Elizabeth, Mount Joy, Penn and Rapho) and Conewego and Londonderry townships in Dauphin County, plus Heidelberg and South Londonderry townships in Lebanon County. Although there are a few volunteers, there are not enough volunteers to respond to all the ambulance calls, so Northwest EMS relies on paid employees.
“They might be up all night and can’t go to work the next day,” Kingsboro said, explaining why the ambulance company needs to rely on paid staff.
Kingsboro said the total number of calls across the four stations is fairly consistent at about 145 to 150 calls per week, but the number of calls per station fluctuate a lot more. And the number of calls can vary a lot by time of day.
“Today, we were steady in the morning; in the afternoon we were not as busy,” Kingsboro said on the day he was interviewed, but he said that can change quite a lot from day to day.