FUNDING, OPERATIONS FOR WASHINGTON CO. AIR AMBULANCE DISCUSSED DURING ANNUAL EMS REPORT

  

Washington County EMS Director Kevin Deramus gave an update on the status of EMS operations during his 2022 annual report to county commissioners on Tuesday. 

Much of the report focused on EMS’ aviation division and encouraging trends for the county’s air ambulance agreement with METRO Aviation.  Deramus presented data showing the amount of helicopter flights as continuing to stay on par with early projections, while the financial side maintains a favorable outlook.

Per Deramus, there have been 167 air transports with METRO from June to December.  The most conservative estimate for a year was 300 transports.  Through six months, the air program has accumulated $922,026 in revenue.

Deramus noted that with the county’s ability as a government entity to waive copays for patients, it has prevented $333,406 from being billed to residents who used air medical services.

In addition to the revenue already received, Deramus said the county and METRO believe they are still due an estimated $1,385,312 in air revenue through the Independent Dispute Resolution (IDR) process.  An IDR board determines what an insurance provider pays for services if the company refuses to pay a certain amount.  He said since the county is billing the least in the region and not overcharging providers, it makes it easier to ensure the county is compensated appropriately.

Through six months, the county is looking at $2,307,338 in combined air revenue received and expected, compared to $1,485,219 in costs , including fixed costs of $1,116,435 and non-fixed costs—like fuel—of $368,783.  After county salaries of $350,500 over six months—$701,000 over a full year—are paid, that is still a net profit of $471,619.  Deramus cautioned, however, that the goal is to break even, not make money off of constituents as a government entity.

Update @2:50 p.m. Thursday: KWHI asked Deramus on Thursday if the $1,385,312 is a percentage of what could be owed to the county or if it is the full amount owed. Deramus said that amount is what the county's billing company believes will be received over time as bills make their way through the IDR process, which includes components like contractual write-offs. He said it is not 100 percent of the amount owed, and that “no one expects we will get 100 percent what is owed.”

KWHI also asked what the experience of other companies has been through the process in terms of receiving what they are asking for. Deramus called the process “brand new,” so experience at it “is not something that anyone really has.” He added, “Our billing company told us to expect the 1.3 [million] additional. How long it takes is a whole other question.”

Over the time of the agreement with METRO, the aircraft has maintained an average in-service percentage of 97.7 percent, compared to 77 percent with the county’s previous vendor.

Deramus told the court that a conversation will need to be had about if and how much the county wants to offer its services to other counties, or stick to taking care of the people at home.

While financial data was a large portion of Deramus’ presentation, he stressed that the tangible effect the air medical program has on the lives of people who use the services is far more important.  He cited a recent report from the Texas A&M University Health Science Center that showed per 100,000 people, Washington County’s deaths because of cardiac disease, stroke or trauma are fewer than those of contiguous counties, despite not having facilities in the county to treat those conditions.

Combining the air and ground divisions, Deramus said roughly 82 percent, or $4,620,953, of EMS’ 2022 budget of $5,666,447 is funded by revenue and fees for service.  The other 18 percent, or $1,045,493, comes from tax contributions.  Deramus said on average, the top 200 EMS systems in the nation are funded on a 60-40 split, with the 60 percent being tax income.  Commissioner Kirk Hanath added that the county’s EMS facilities were built using donations or Texas Ambulance Supplemental Payment funding, not tax dollars. 

Hanath reminded the public that the data provided by Deramus is available for anyone to see.  He commended Deramus on the work he has done with the EMS department, saying the team he has put together and the culture he has created is “phenomenal.” 

Commissioner Candice Bullock suggested organizing a public event in the future for residents to learn more about the ins and outs of the EMS program and clear up any misconceptions about how it operates.