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Published May 13th, 2020
Fire district ambulance revenue plummets since onset of pandemic

In March and April, the Moraga-Orinda Fire District saw such a steep decline in hospital transports that the district lowered its ambulance revenue forecast by nearly $400,000 for this fiscal year.
It is unclear how long the dearth in ambulance demand will continue. According to Battalion Chief Jerry Lee, with people staying home since the onset of COVID-19 there is less potential for injuries, and with not as many people on the roads there have been fewer traffic accidents. Patients have used alternative methods for their health care evaluation, such as a Zoom consultation, instead of visiting the doctor.
"People don't want to go to the hospital because hospitals are generally viewed as having a higher potential for COVID-19 exposure," Lee said.
MOFD ran 1,605 ambulance transports in 2018 and 1,554 in 2019, nearly all to either John Muir Medical Center or Kaiser Permanente in Walnut Creek. In March the district transported patients to hospitals 111 times, and in April, 60 times - far below its 133 monthly average. The district is preparing for the steep drop in transports to continue, as it projects a decrease in ambulance revenue from $1.3 million this year to $500,000 next year.
"If that's all we're going to get, that will be a tough pill to swallow," Director John Jex said. "If we were a commercial ambulance operation we'd be bankrupt."
Fire Chief Dave Winnacker listed options for higher ambulance revenue. Increase the rates, which recently occurred. Add fees, such as a facilities fee to institutional users. Or require payments for patient transport beyond district reimbursement levels.
MOFD charges $2,300 for an ambulance transport but its reimbursement rates come nowhere near that figure. Medicare payments range from $350 to $800, Medi-Cal payments are somewhat lower and reimbursements from private insurers widely vary. Anything higher than the district reimbursement rate is forgiven for district residents.
Should the district stop writing off ambulance charges in excess of its reimbursement rates, "That would result in district residents receiving a significant bill for transport from an MOFD ambulance," Winnacker said.
"We need to take a hard look at those numbers and really address a change," Jex said.

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