NH ambulance companies say that whereas 911 service is OK, different medical transport is underneath growing pressure

Add medical transport by ambulance to the listing of health-care programs in New Hampshire that claims they’re being strained to the breaking level.

“On the finish of the day, the disaster is all about cash,” stated Justin Van Etten, govt director of the New Hampshire Ambulance Affiliation, the commerce group for ambulance companies and different medical-transport operations owned by communities, hospitals and personal firms, each non-profit and for-profit.

The group on Tuesday launched a report titled “The State of Emergency in New Hampshire” which argues that low reimbursement charges for Medicaid sufferers and from personal insurance coverage firms has brought on low pay that’s contributing to a scarcity of EMTs and paramedics who’re keen to work in ambulances, which in flip contributes to crowded hospitals and lengthy wait occasions for well being care, significantly in rural areas.

“If we don’t discover more cash within the subsequent 3 to six months, this example goes to get extraordinarily dangerous,” Van Etten stated Tuesday. “I simply needed to inform one of many largest hospitals within the state that they’re not going to have paramedic stage protection for the foreseeable future. There’s simply no person left to work them.”

Three ambulance firms have shut down in New Hampshire this yr, together with Finest Care in Gilford.

Related concern about reimbursement charges has been expressed by many elements of the health-care system starting from the Decisions for Independence program for individuals who wish to age at residence, to youth mental-health companies.

Two payments being thought of by the legislature – SB86 and HB2 – would improve reimbursement charges for Medicaid sufferers in some conditions and for medical transport.

“We’re attempting to battle it on each entrance,” stated Sen. Sue Prentis, D-Lebanon, who’s a paramedic and was previously head of Emergency Medical Companies within the state. “Final yr was the primary yr in 17 that we received any sort of substantive improve only for ambulances. … It’s lastly as much as 50% of the Medicare fee.”

New Hampshire’s growing older inhabitants contributes to the issue.

Van Etten stated that the scenario is just not as dire for 911 service, which will get taxpayer assist from communities, however that is little comfort for non-emergency transport corresponding to when a affected person with a cardiac situation must be taken to a specialty hospital.

“In case you’re in Harmony you’re fantastic, however in the event you go to a smaller rural hospital in New Hampshire … we’re seeing elevated conditions the place individuals are ready days to get to an even bigger hospital,” he stated.

Equally, New Hampshire hospital executives have stated {that a} scarcity of accessible beds is attributable to lack of transport to take sufferers who’re recovering from the hospital to a long-term care facility.

Compounding the issue has been extra competitors for EMTs and paramedics, though the variety of such skilled personnel within the state has stayed roughly static, round 5,000, for years, Van Etten stated.

“At pressing care clinics now, they’re largely staffed by EMTs. All types of companies now require EMTs on workers. … An EMT would possibly give you the chance to earn more money working at Canobie Lake Park for the summer time – that job didn’t used to exist,” Van Etten stated.

Fee from personal insurance coverage can be an issue, he stated: “One of many largest insurance coverage companies within the state has began paying lower than they paid a decade in the past. … I might transport two sufferers, the identical companies, identical distance, could possibly be paid by the identical insurance coverage. One time they’d (reimburse) $375, subsequent time $4,200. There isn’t any rhyme or purpose to what insurance coverage firms pay.”

Apart from more cash, the report says a attainable resolution could possibly be to “manage EMS (Emergency Medical Service) on the county or regional ranges to create a security web and economies of scale from shared companies.”

Final month Cheshire County grew to become the primary New Hampshire county to begin its personal EMS service following the closure of personal DiLuzio Ambulance in Keene.