The District’s mayor said Wednesday she will seek legislation requiring insurance providers to pay the entire costs for ambulance rides and other medical services by first responders, as authorities continue to grapple with ways to improve the emergency response system.
The bill — the Affordable Emergency Transportation and Pre-Hospital Medical Services Amendment Act — could be introduced in the coming weeks. The goal is to help the department keep up with the fast-growing number of medical calls that have strained the city’s system.
Mayor Muriel E. Bowser (D) said requiring insurance companies to pay would help ensure the fire department is reimbursed for care not only given during transport but also while at the scene of an emergency. Under current rules, the city only gets reimbursed or paid for care that ends with a transport, anywhere from $428 for basic treatment to $735 for advanced life support.
While the District sends bills for transports, it does not seek to collect on those that are not paid. In fiscal 2016, the city collected full or partial payment in 69 percent of runs. The department transported 119,230 patients during that time. Requiring insurance companies to foot the entire bill could ensure nearly full compliance.
The America’s Health Insurance Plans, a national trade association for the health-care industry, urged caution.
In a Thursday statement, the group said that “consumers deserve affordable coverage and access to the care they need, and health plans cover emergency care today. While we will be evaluating the proposal, we are concerned that additional mandates may increase premiums and costs for consumers.”
The mayor’s proposal is one of several ways city leaders are seeking to manage the increase in 911 medical calls, many from people suffering from minor ailments and injuries. The department says that nearly 50 percent of the roughly 500 daily medical 911 calls are deemed at the time of dispatch to be nonemergency. That number jumps to 72 percent after personnel arrive at the scene.
Even eliminating emergency runs to those people will not fully alleviate all problems. Fire officials say that because of increased call volume — 24 percent since 2013 — the District will have to hire additional firefighters who are also paramedics.
“Over the past two years, I have remained committed to fulfilling my promise to fix our Fire and Emergency Medical Services Department, and we will keep the improvements going — the people of D.C. deserve nothing less,” Bowser said at a news conference outside the fire station for Engine 30 in Northeast Washington.
In March 2016, Bowser brought in a private ambulance company, AMR, to treat and transport those with minor illnesses and injuries and preserve city resources for the patients in more urgent need.
Another part of the plan is the Integrated Health Care Collaborative, run by Robert Holman, the fire department’s interim medical director. The effort, which aims to help people who don’t need immediate medical attention get the care they need, puts a nurse in the 911 center to answer patient questions and helps people in nonemergency situations get to medical providers.
Since 2015, the District has hired nearly 100 more firefighters trained as paramedics or emergency medical technicians.
Officials also said that efforts have been put in place to improve care and response times, and they have increased hours dedicated to training.
Gregory M. Dean, the District’s fire chief, said response times for first arriving have improved by 41 seconds, and the average ambulance response time has dipped from eight minutes and seven seconds to six minutes and 30 seconds.
But officials said that the use of private ambulances has not solved all problems. A report shows the department “still struggles with the availability of medic units and our response times for first arriving paramedic on critical medical calls have not improved.”
Said Dean: “We have made great strides, but we have even more work to do. There needs to be more advanced-life-support units available for our most critical patients.”