By DAN TOMASELLO
LYNNFIELD — The Select Board approved new emergency medical services (EMS) rates during an early morning meeting on Zoom teleconference on Sept. 2.
Fire Chief/Emergency Management Director Glenn Davis said he is frequently reviewing the ambulance transport billing rates that fund the Emergency Medical Service Enterprise Fund’s budget.
“We are constantly looking at the billing rates for opportunity to make sure we are capturing everything that we possibly can,” said Davis. “Our billing company is Pro EMS. They do collections for a lot of the agencies around us.”
Davis said Armstrong Ambulance, which is a private company, provides EMS services to Melrose, Saugus and Stoneham.
“They just took over the Melrose contract, so that is the most recent contract with billing rates that were available to me,” said Davis. “I have reached out to a couple of other communities and have not heard back.”
After reviewing Armstrong’s billing rates, Davis proposed increasing the Fire Department’s EMS rates.
“Our last increase was a couple of years ago,” said Davis. “The last formal survey that Pro EMS did was August 2024.”
While Davis said the Fire Department used to send an “à la carte bill for what services were provided” over 10 years ago, he said “all communities now enter in what they call a bundled billing model.”
“All of the payers preferred and went to bundled billing,” said Davis.”
Davis said the Fire Department provides “three categories of service” to patients.
“It’s either basic life support, advanced life support level 1 or advanced life support level 2,” said Davis. “That billing is based on what services and what critical level of care is provided to the patient.”
If a resident suffers a knee injury in a fall, Davis said the Fire Department will provide basic life support to a patient who is transported to an area hospital.
“Once we start doing any interventions with intravenous, monitoring or giving medications, it becomes advanced life support level 1,” said Davis. “For more critical patients like a cardiac arrest or a real involved patient with multiple medications and multiple interventions rise to that advanced life support level 2.”
Davis said the previous ambulance mileage rate was $50 mile per mile. He said the basic life support rate was $1,650 per mile, the advanced life support level 1 rate was $2,350 per mile and the advanced life support level 2 rate was $3,450 per mile.
“This is gross billing,” said Davis. “Almost every single provider that we bill through Pro EMS has a contracted rate. They have a maximum regardless of what our gross billing is. We could bill them $5,000, but if they allow $2,300, that is what they pay. What we wouldn’t want to do is bill that same provider that would pay up to $2,300 and only bill them $2,100 because then we would be leaving money on the table. They would only provide or reimburse the billed amount rather than the contractual maximum. We want to make sure that we are covering the maximum amount, and that is what we are doing with our proposed changes.”
Davis said the proposed increased EMS billing rates would charge $70 per mile for ambulance mileage. He said the basic life support rate would increase to $2,700 per mile, the advanced life support level 1 rate would go up to $3,300 per mile and the advanced life support level 2 rate would increase to $4,000 mile.
Select Board Chair Phil Crawford expressed his support for the proposed changes.
“We have to make these adjustments occasionally to stay current with our own costs and expenses,” said Crawford. “These are in line with neighboring communities, so I have no problem with this.”
In response to a question from Select Board member Dick Dalton, Davis said new rules and regulations has led to an “increased delay” on turnaround times when firefighters, who are also paramedics or EMTs, drop off patients at hospitals.
“All of the emergency rooms are busy,” said Davis. “We could never drop off a patient and walk away. We always have to do a face-to-face report, and we have to give that report to a nurse. They then assume care of that patient. Until that face-to-face occurs, we still own that patient and are responsible for their medical condition and their care. A lot of the emergency departments are very backed up, and we can have a longer turnaround. That is especially with the closing of Union Hospital. We used to be able to do a transport, turnaround and be back in the station in under 30 minutes with a quick handover to Union.”
Davis said Lahey Hospital and Medical Center in Burlington is the Fire Department’s “primary hospital” because “it is direct travel on the highway.”
“(Lahey’s) Emergency Department is busy,” said Davis. “By the time we give our report, it can be delayed sometimes up to 30 minutes on scene waiting to hand over a patient. Our average turnaround time is approaching an hour now.”
Crawford recalled that he discussed the Fire Department’s turnaround times for transporting patients while Partners HealthCare was going through the approval process to close Union Hospital and expand Salem Hospital.
After the discussion, Crawford and Dalton both voted to adopt the ambulance/EMS rates. Select Board Vice Chair Alexis Leahy was not present at the 8 a.m. meeting.