Commissioners step out of ambulance rates decision

Commission counsel says Sweetwater Medics' pricing decisions are up to them and not the commission

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By Ann Jantz, Wyo4News

SWEETWATER COUNTY, WYOMING (Nov. 19, 2019) — The Sweetwater County Commission left the decision to raise ambulance service rates to Sweetwater Medics, saying as a private business it is solely Sweetwater Medics’ decision to make.

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Sweetwater Medics Director Ron Gatti approached the commissioners at their regular meeting Tuesday to inform them of the proposed rate increases. He said it was his intention to keep the commissioners informed and to be open and transparent with community members.

“We want people to know what we’re doing,” Gatti said.

According to Gatti, the fees Sweetwater Medics currently charges are “drastically lower” than the Medicare national average for the codes referenced in the information provided to the commissioners.

Some of the proposed fee schedule changes include:

  • Specialty care transport; increase from $1,716 to $4,000
  • Advanced Life Support (ALS) 1, non-emergency; increase from $1,052.87 to $1,800
  • ALS 1, emergency; increase from $1,082.12 to $3,000
  • ALS 2; increase from $1,352 to $3,500
  • Basic Life Support (BLS), non-emergency; increase from $650 to $1,250
  • BLS, emergency; $702 to $1,700

In its efforts to become a sustainable service, Gatti believes raising rates is part of that conversation.

Gatti answered some questions that were provided to him by Commissioner Roy Lloyd:

  • Are insurance companies going to pay more if the rates are increased?

Gatti said some companies will and some won’t.

  • Will the rate increases also increase non-payments and write-offs?

Gatti believes it will, but Sweetwater Medics will not withhold services regardless.

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Commission Chairman Wally Johnson noted Sweetwater Medics in the past has stated it was headed toward bankruptcy; now it sounds “like you’re sticking with it.” Johnson asked if Sweetwater Medics is profitable.

Gatti said it is not; he would like to see the ambulance service under the umbrella of a nonprofit, which itself could change many of the services they offer. Most important, however, is maintaining sustainability of an essential service, which itself would “appreciate some economy of scale,” he added.

Johnson also asked how Sweetwater Medics expects to continue operations when it cannot sustain itself. He said the county pays them for the service, which also garners the county a certain amount of pressure from the public. Gatti said he realizes this and would be okay if the county went to bid on the service in the future and was able to find an ambulance service that could to the job for less money.

Some questions from the commissioners could not be answered by Gatti. Commissioner Lauren Schoenfeld asked what percentage of Sweetwater Medics’ income comes from the county. Lloyd also asked why the company’s rates have not been evaluated on a yearly basis. Gatti said he didn’t have information in front of him to answer Schoenfeld; he also said he did not know why an evaluation of rates did not happen.

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Commissioner Randy Wendling questioned commission counsel about the right protocol in this instance. Deputy County Attorney John DeLeon said it set a good precedence to have Sweetwater Medics keep the commissioners informed, but the connection between the two entities is one of an agreement instead of a contract.

“Sweetwater Medics makes determination of pricing on their own,” DeLeon said.

Commissioner Jeff Smith agreed, saying the commission shouldn’t be involved in a private entity’s business decisions.

“It’s your business, it’s your prerogative,” Smith said. “But thanks for coming, because we have a stake in it.”

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