Monday, October 17, 2011

Ambulance Inflation Factor to increase by 2.4% in 2012- Part II

If the bonus payments go away…
You’ll recall that bonus payments of 2% (urban), 3% (rural) and 22.6% (super-rural) are currently being added to Medicare payments as part of the Medicare Ambulance Relief provisions in the Tax Extenders Act of 2009, which was once again extended by Congress retroactively in March of this year.  Those extensions are now set to expire at the end of the year.

If Congress does not once again act to extend the bonus payments, or if they fail to push passage of the pending Medicare Ambulance Access Preservation Act of 2011 (MAAPA) that would potentially add 6% additional payments to the Medicare Ambulance Fee Schedule, the result will be a decrease in ambulance payments for the second year in a row for transports originating in rural and super-rural zip code locations.

Only the urban transports would increase, but not by much.


The good news first…
Ambulance providers and suppliers transporting Medicare patients from an urban zip code will lose the 2% bonus payment but then pick up the 2.4% AIF increase in the new year.  The result would potentially net out to a 0.4% increase in Medicare reimbursements in those areas.

It’s a small increase, but it’s an increase.

That’s the good news.  Now for the bad.

A potential two-year combined loss of 0.7%...
Ambulance providers and suppliers that conduct transports that originate in a rural zip code will lose the 3% bonus payment but then subsequently also pick up the 2.4% AIF increase in the New Year.  The net result will see reimbursements slashed in these scenarios by 0.6%.

If this happens, it will signal a combined increase of 0.7% across two years, as rural ambulance services already realized a loss of 0.1% from the AIF in 2011 coupled with the potential decrease of 0.6% in 2012.

The biggest losers…
The Super-Rural providers, those in the most remote pockets of our Country, stand to lose the most and in areas where they can’t afford to lose precious dollars.

Ambulance providers and suppliers that conduct transports that originate in super-rural zip codes, will lose the bonus payment factor of a whopping 22.6% while only picking up an additional 2.4% via the AIF to offset the loss.

This will potentially translate into a Medicare Ambulance fee schedule decrease for these transport scenarios of 20.2%!

Rising costs and tough economic times…
Given rising costs for benefits, wages, vehicles and maintenance, supplies, liability insurances and the list goes on and on, can any ambulance service in the United States afford to lose a single dime of reimbursement, let alone potentially losing 20.2% of what turns out to be the largest payer source for most ambulance companies?

The greying of America is pressing an even larger burden on everyone in the industry.  At a time when call volumes are spiraling upward, the amount of money we all have to work with is shrinking.  So we’re called on to provide more services and do so with fewer resources.

It’s a true recipe for disaster!

The light at the end of the tunnel…
However, there are strategies that can help you weather the storm.  Enhanced Management Services can help your ambulance service develop and implement strategies that will help you weather the gathering storm, if it comes to pass.

Enhanced will “enhance” your cash flow, give you unparalleled customer service, provide you with cutting-edge technology tools to help you track and monitor your billing program at every level and all the while keep you compliant and in-the-know about all the pending changes.

Call us today and tell us how we can “enhance” your billing program!
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