San Diego has taken control of the city's ambulance services with hopes of improving response times and eliminating financial incentives for private companies, The San Diego Union Tribune reported July 31.
Falck USA and American Medical Response, both private ambulance companies, will continue to transport patients, but the city will control staffing, dispatch, deployment, billing and other aspects. To reduce some of the financial risk associated with the new model, the city has approved a 12.5 percent increase over two years in fees for patients.
The increase will affect only 23 percent of ambulance rides that are not covered by Medi-Cal or Medicare, according to the report. The rate will increase from $2,805 to $2,945 effective immediately and in July 2024 increase to $3,151.
The new model switched the payment flow; now the city will pay Falck and AMR $64.7 million to operate ambulances and charge patients itself instead of the companies paying $9 million a year for the right to charge patients.
Experts say the new model shows promise, but if problems arise with the reimbursement model, the city could lose up to $18 million a year.
To mitigate that risk, the mayor has required the Fire Department to use profits from ambulance services to create a reserve fund before adding services. The city's fire chief, meanwhile, recently said he plans to spend profits on new programs such as nurse triage, telemedicine and street-based interventions for homeless patients.