CLEVELAND — In an effort to get the city’s EMS rates more in line with other peer cities, Cleveland officials recently increased what it bills insurance providers to transport a patient, marking the first time in nearly two decades that they have done so. The vast majority of the additional revenue will come from the reimbursements from private insurance companies and officials from CARE Local 1975, the EMS union, are imploring city officials to use that revenue to invest in the division’s workforce.
On Wednesday, the Cleveland City Council’s Safety Committee held a two hour hearing on the current state of the Division of EMS as well has the city’s recent decision to increase EMS rates for the first time in nearly two decades. The rate increases are more than double the previous rates, amounting to $750 to $1300, depending on the level of care needed.
After transporting a patient, the city will request reimbursement from the patient’s insurance provider, whether it be Medicaid, Medicare or private insurance. As much as 94% of the reimbursements collected by the City of Cleveland come from Medicare and Medicaid. City Controller Jim Gentile told council members that the overwhelming majority of the $1.2 million in additional revenue expected from this rate increase will be paid out by private insurance companies.
“$1.1 million of the $1.2 million is actually from the private insurance carriers,” Gentile said. “This kind of gets us on par with other big cities. It’s been 20 years since we increased it so we know everything has gone up in the past 20 years.”
Because Medicare and Medicaid largely place caps on the amount that they will reimburse, the vast majority of residents that require an EMS transport won’t see a difference, officials said. The amount that Cleveland bills insurance providers also does not cover the division’s entire per-transport cost, officials said. Although the budget at the Division of EMS has increased by about $10 million over the past two decades despite the fact that transport fees had previously remained unchanged.
"This is still under the price of what it costs to pick people up,” Gentile said. “If we factored in what it really costs to run EMS, these rates that we would have to raise it to would be much higher than what we raised it to.”
Ward 17 Councilman Charles Slife, who has largely spearheaded the push to increase the EMS rates, stressed that the rate increases are not to be viewed as a revenue generator.
“This will never be revenue neutral. However, I think the shared goal is making sure that we are not subsidizing EMS to the detriment of other city services and to the detriment of EMS itself,” Slife said.
Timothy Sommerfelt, the secretary at CARE Local 1975, addressed city officials and council members during the public comment period at Wednesday’s hearing. Acknowledging that the union and city remain in negotiations for a new labor agreement, Sommerfelt urged city leaders to consider making further investments into the division’s workforce.
“All the ambulances, the cots, the monitors, they’re worthless without having the paramedics to operate them. That’s why CARE is in favor of these increases to the EMS rates. Just like we’ve invested in equipment, so too do we need in our EMS workforce,” Sommerfelt said.
Sommerfelt highlighted some of the pay disparities between EMS and other public safety agencies, in addition to the more lengthy training requirements, paramedics can only retire after 33 years of service, compared to the 25 year requirement for police and fire. CARE and other EMS professionals are working with state leaders to change that.
Those disparities, Sommerfelt said, make for a tough sell when trying to recruit new EMTs and paramedics, Sommerfelt said.
“We want you to work an extra seven years. You’re going to make less money. You’re going to have a higher workload,” Sommerfelt said. “And, oh, if you take your talents to the suburbs, you’re going to make more starting than what we top-out at. I don’t know how we can sell a young person on that career.”
Although the Division of EMS will have a new batch of cadets entering the academy in the coming weeks, the staffing crunch at the division won’t be going away anytime soon. Currently, the division is short 50 frontline staff members. A total of 21 paramedic-EMTs have resigned so far this year.
“To learn today that we are down 50 is troubling. I will be honest. It’s troubling that we’re down 50,” said Councilman Mike Polensek (Ward 8).”
