Congratulations, Joel, and Three Rivers Ambulance Authority Team!!

For perspective – note Indiana’s Medicaid rate increase mentioned in the Editorial; from $160 per ambulance run to $470; which is essentially Medicare Parity, something EMS agencies across the country have been advocating for. That is a significant increase, especially when national cost report data reveals that the average cost of putting an ambulance in front of an address was about $2,400 in 2021, and Medicaid patients represent 15%-30%.

----------------------------

TRAA turnaround a win-win for all so far

Editorial board | The Journal Gazette

Jul 22, 2023

https://www.journalgazette.net/opinion/editorials/traa-turnaround-a-win-win-for-all-so-far/article_10ace20e-27fe-11ee-9d44-07e2c57a99c7.html

Since Three Rivers Ambulance Authority fired PatientCare EMS Solutions last September due to its abysmal record in meeting performance goals, the quasi-governmental nonprofit has made rapid progress in improving service.

In January, the ambulance authority met the 8½-minute response goal on calls for service 84% of the time. On Friday, TRAA reported meeting that mark during 89.5% of its ambulance runs, up from just 64% the previous year.

“Ninety percent kind of is the magic number for us. And for us to be at that point this far into the month of July is actually incredible,” Joel Benz, executive director of the ambulance authority, told The Journal Gazette Friday.

Another mark of the TRAA turnaround was announced in June at its board of directors meeting: Through managing expenses, an increase in federal reimbursements and a new billing system, the ambulance authority might not need to draw upon the city and county funds it requested earlier in the year.

The city of Fort Wayne pledged up to $3 million to TRAA in March, and the ambulance authority has discussed financial assistance with the Allen County Commissioners. In May, Benz reported the Fort Wayne City Council allowed TRAA to retain $400,000 it usually pays the city for advanced life-support training each year.

The ambulance authority has used the $400,000, but hasn’t requested any of the $3 million.

TRAA Finance Manager Carrie Henry told board members at their June 22 meeting the ambulance authority is operating at a loss of $213,131 for the year – a vast improvement over the $1.5 million the nonprofit had anticipated.

The deficit reduction was achieved through better management of expenses and hiring a new billing company, Med-Bill, in September – the latter having the greatest impact on the bottom line, Benz said.

Before hiring Med-Bill, TRAA was collecting between $550,000 and $600,000 each month. Med-Bill brought in $1.1 million in May alone.

Reimbursements from Medicaid will increase from $160 per ambulance run to $470 this month, while Medicare reimbursements will go up 8%, Benz said at the June meeting. Medicaid patients accounted for about a third of TRAA’s runs last year, and Medicare patients made up another 43%.

Those reimbursement increases will positively impact the ambulance authority’s revenue. But Allen County’s launch of fire districts in the northeast and southwest this January could adversely affect TRAA revenue in 2024.

The northeast fire district will include the current fire territory’s municipalities of Grabill and Leo-Cedarville, and Cedar Creek, Milan, Scipio and Springfield townships. A fire district southwest will cover unincorporated Lafayette, Pleasant and Wayne townships and Zanesville.

TRAA has 61 full-time ambulance employees. Full staff for the ambulance authority is 82 full-time employees, Mike Manz, director of operations, told the TRAA board. Its starting wage for a paramedic is about $56,000 a year. Benz said the county is looking at paying paramedics $73,000 annually.

“I think we made significant progress, but part of the story is we are still underpaid here compared to county services,” Benz said. “I’ve got a half-dozen paramedics that are looking at moving to the county, probably more than that.”

TRAA’s transition to run medics and ambulance services has brought down response times and reduced costs. That decision has been a win for its employees, city residents, and county fire departments and residents.

There remain significant challenges for TRAA, especially regarding a shortage of trained paramedics and the inevitable resulting wage competition. But just 10 months into TRAA’s takeover of the ambulance authority, there has been dramatic improvement in the all-important response times, which undoubtedly improve patient outcomes, costs are down and revenue is up.

There are too many variables in the mix for 2024 to know whether this progress can continue without additional help from the city or county, but it has been a win-win for all so far.