Texas is considering new Medicaid reimbursement rates for ambulance services that providers say could help stabilize access to EMS across the state.
During a public rate hearing Tuesday, providers applauded the higher Medicaid rates proposed by the Texas Health and Human Services Commission that would raise reimbursement for certain ambulance services by up to 50%.
“The proposed rates reflect the first meaningful adjustment to Medicaid reimbursement in nearly 17 years,” said Michael Furrh, president of the Texas EMS Alliance’s Board of Directors. “Adjusting Medicaid rates as proposed will improve the sustainability of EMS and ensure that most vulnerable Texans can continue to access high-quality, 911 medical response and ambulance transport.”
The proposed increase comes as HHSC considers significant cuts to other Medicaid services, including dozens of medical supply services.
Texas already has a gap in emergency medical and ambulance services. Almost 95% of Texas counties have areas known as “ambulance deserts,” meaning people or places are 25 minutes or more away from an ambulance station. In addition, EMS agencies are still recovering from significant staffing shortages caused by the COVID-19 pandemic.
Eric Maloney, a rural fire chief in Kerr County, said the Kerrville Fire Department provides emergency medical care across a 1,000-square-mile area. Over the past decade, the department has seen significant increases in operating costs, including staffing, fuel and medical equipment.
“These rising costs did not get matched by reimbursement rates, placing strain on our ability to maintain reliable and timely emergency medical services,” Maloney said.
He said he appreciated the state’s consideration of rural communities with the proposed increase.
Rural EMS providers can be tasked with covering a larger area with fewer resources, making issues that all providers face even worse. In addition to having less access to new recruits, rural providers often serve a larger uninsured population with fewer community partners.
Texas has seen 14 rural hospital closures in the past decade. More than half of the state’s 154 remaining rural hospitals are at risk of closure — and that number could increase due to federal policy changes that affect funding that hospitals rely on.
Higher reimbursement rates can play a key role in how EMS providers are able to adapt and meet community needs.
Brett Coghlan, president of the Texas Ambulance Association, said ambulance providers are a critical part of the Texas health care safety net.
“The new Texas Medicaid ambulance reimbursement [rate] would be a meaningful and immediate step towards stabilization of ambulance services across the state,” Coghlan said during the hearing. “This change will help preserve access to emergency care, particularly in rural and underserved communities where providers are operating on extremely thin margins and some cases facing the risk of severe of service reduction or closure.”
If approved, the new rates would take effect in September.
Rachel Harracksingh, director of Texas Ambulance Association, said the state should consider an annual increase based on inflation “only to make sure it doesn’t take 17 years before we get the next increase.”
“We don’t have a choice when it comes to providing service, especially if we’re doing 911,” Harracksingh said. “We pick up patients regardless of their ability to pay. That’s why I think it would be a great idea to do the adjuster.”
Great Job Abigail Ruhman & the Team @ Texas Public Radio for sharing this story.
