Ambulance Operating Cost

Messages
1,251
Location
Akron, OH
I know some of you guys manage emergency fleets, so maybe you can shed some insight on this. I saw a post online where a guy was being invoiced over $29 per mile for land-based ambulance services. How much does an ambulance cost per mile to operate? I could see $1/mile, maybe even $2/mile, but unless the thing demands molten gold for fuel and platinum-laden motor oil, I don't get $29/mile.
 

ALS

Messages
1,862
Location
Pittsburgh
Lets see there is the driver that gets paid, at least one paramedic that also gets paid, benefits, insurance, wear and tear, depreciation on original cost of the vehicle. Plus your still paying for the time the personnel are sitting around waiting for a call, and probably more expenses I can't think of at the moment.
 
Messages
341
Location
Upstate, NY
You are also paying for the building that the ambulance is sitting in, and the ambulance next to it that isn't being used right now.
 

TomJones76

Thread starter
Messages
1,251
Location
Akron, OH
I was really asking about the VEHICLE's operating costs, but I should certainly have been clearer when I asked. I understand that the business has overhead, but this guy received a separate (and massive) invoice for "Ambulance Services" on top of mileage. At my job we charge something like 50 cents per mile on our way to service calls, which does a good job of covering the full-sized light duty pick-up trucks and cargo vans that our service guys drive. We also charge our standard labor rate ($85-$300/hr depending on product serviced) for drive time.
 
Messages
39,805
Location
Pottstown, PA
The last time we had to pay out of pocket for amulance transport it was $285 for routine transport and $3/mile from pickup to wherever you chose to be delivered (one of two area hospitals). I doubt that the true operating costs ..as far as time/mile running is anymore than any diesel pickup owner. The main expense involved with the ambulance ..at least what results in the big bill is the term "Non Profit" or "Not for Profit" ..which ends up being anything but [I dont know]
 
Messages
694
Location
Saskatchewan, Canada
I own a taxi company and charge $1/km for hiway service. That's roughly $1.20US/mile or $75/loaded hour if you want to think of it that way. Sounds rediculously high doesn't it? My costs are nowhere near that but the problem I run into is that I operate in a small town and I'm the only service for 30 miles around. So I have to have enough manpower and equiment to handle anything that comes my way 24/7/365, I can't just pass along business to a competitor when the crap hits the fan. So I have 7 vehicles and 95% of the time there are only 2 or 3 actually out making money. The rest just sit and wait for the remaning 5% of the time when it's insanely busy and they are needed. So really 2 or 3 of the vehicles are paying for the whole fleet. But even when a car doesn't move it costs alot of money ie-car payment, insurance, garage costs, etc. If I could have all 7 cars out making money 24/7 I could charge alot less and still make the same profit. I'm sure the ambulance business faces the same things. Most of the time you are sitting around doing nothing just waiting for a call. But employees and everything else still need to be paid. Plus you have to have enough equiment and employees to cover peak periods, which amount to maybe 5% of the time, and you have no idea when those peak periods are coming, so everything and everyone has to be ready to go at a moments notice 24/7. That cost big dollars. So when you get a huge bill for an ambulance ride, you're also paying for the previous "X" hours that the paramedics and ambulance sat around waiting for you to call. Paramedics are paid good wages, a fully equipped ambulance could cost $100k+, and I don't even want to think about what their insurance costs. I'm sure the high cost to use these services is justified.
 

blupupher

Site Donor 2021
Messages
6,946
Location
Katy, Republic of Texas
quote:
Originally posted by olympic: ...Paramedics are paid good wages, ...
Really, I wish someone would tell my boss so I could quit my 2 other jobs. As for the $29/mile charge, that sounds very high. Most charges are set by Medicare (most have a high and low charge amount, most govt or NFP services charge the lower to mid range, for profit services usualy charge the max). I will see what my City charges per mile. I think it is a flat rate for the 1st 5 miles then a fee per mile after that.
 
Messages
429
Location
US
quote:
Originally posted by blupupher:
quote:
Originally posted by olympic: ...Paramedics are paid good wages, ...
Really, I wish someone would tell my boss so I could quit my 2 other jobs. As for the $29/mile charge, that sounds very high. Most charges are set by Medicare (most have a high and low charge amount, most govt or NFP services charge the lower to mid range, for profit services usualy charge the max). I will see what my City charges per mile. I think it is a flat rate for the 1st 5 miles then a fee per mile after that.

Same here... Im not sure what it cost but there are many cost associated besides gas and oil. Training ocst, thousands of dollars worth of equipment and many other things I cant think of.
 
Messages
93
Location
west coast
Paramedics up in British Columbia here are paid very well. Although our health care is all goverment run. When I got my ride in an ambulance it cost the insurance company $600, It wasn't that far of a drive.
 
Messages
39,805
Location
Pottstown, PA
Here it depends (the cost). For example "routine" transport was $285+...now if you actually do anything as far as treatment (IV, O2, even bandages for deep wounds) then it goes to "Advanced life support" ..even if it's a "routine" transport of a patient who normally has oxygen as a routine treatment (asthsma, etc.) ..which jacks the bill to $685+ (this is higher now). The reason most of these charges are bogus is that they have no difficulty running within the confines of the Medicare, DPW, etc guidelines and still remaining functional. Since this is about 50-60% of the "posted fees" ..it's sorta a game of semantics. The "real" rate is set by the agencies ..and those who are not covered fully by their insurance carrier get to foot the "bonus" bill. They usually get their full fee from auto insurance carriers for emergency transport services.
 
Messages
472
Location
Cleveland, GA
My FD charges a FLAT $250 per trip, no mileage addition. It doesn't matter if it is a BS stump toe call with nothing used or cardiac call where I push $500 worth of medication. Most departments services here in Metro Atl charge MUCH more. With many, a 10 mile transport can cost $1000-1200. Is it worth it, up to the people being hauled. Some FD's around here are charging an "assessment" fee for coming out if you don't go to the hospital. This IS NOT covered by unsurance. I think this is an excellent idea (cut down on the crap!!). In my area, 99% of the people are NOT from the united states. They think they can call 911 for ANYTHING. I have went out to tell someone how much Tylenol to give to their child, how many ibuprofen they can take for a headache, bandaid removal because "the stickiness pulls my hair", and a page full of BS!! Clowns like this is why our health care is in the shape it is in and why it costs us an arm and a leg. People abuse the benefits they have and people without benefits get a free ride from those of us that actually work and pay for them. My opinion...If you call an ambulance, don't gripe about what it costs. If you are able to gripe, either the ambulance crew did their job well, or you didn't need an ambulance in the first place. Also, most service charge such a high price to collect what they can from those that have insurance/ability to pay to cover those sorry people that don't pay.
 

TomJones76

Thread starter
Messages
1,251
Location
Akron, OH
The guy I was discussing this with got charged by the mile, per person, even though he paid for TWO people being transported in the same ambulance. His insurance paid 80% of the ambulance bill for 3 people and he still got stick paying $1500 for his 20%.
 
Messages
12,385
Location
Northern CA
quote:
Originally posted by Gary Allan: The reason most of these charges are bogus is that they have no difficulty running within the confines of the Medicare, DPW, etc guidelines and still remaining functional. Since this is about 50-60% of the "posted fees" ..it's sorta a game of semantics. The "real" rate is set by the agencies ..and those who are not covered fully by their insurance carrier get to foot the "bonus" bill. They usually get their full fee from auto insurance carriers for emergency transport services.
Do you know for a fact that they are making a profit at Medicare rates, or are the breaking even/taking a small loss and gouging other customers to make up for it?
 
Messages
39,805
Location
Pottstown, PA
Well, my uncle is the Fire Chief in Norton, MA (Nahtun). He said that basically he applies for all the grants that are available to maintain units. I didn't get the clear take on how the "list price" is set ..but he basically said that they never, except with auto carriers, get the full fee. Most transport is paid by Medicare, due to the aging population. Private pay, or whatever is left over from medical insurance is typically a lost cause ..or rather is not usually collected in full. He considers it a bonus if they actually collect their full fee. There are plenty of for profit ambulance transport services that do NO emergency service. They function on DPW, Medicare, AARP, and other "managed or regulated" fee structures. Their rigs roll ..their drivers get paid ..and the front office/owner lives large. Now surely the cost of keeping state of the art emergency service/mobile intensive care vehicles is expensive when compared to routine transport, but it appears that the expensive part of it is, more or less, used to soak up any revenue that would be termed "profit" in otherwise routine tranport environments. In Pottstown, the local ambulance company (for a population of 21,000 people =pottstown "metro" area [Big Grin] ) has 15 ambulances. 9 of them never leave the ambilicals. They are there to qualify for "per unit" grants. They are retired units that are typically sold by smaller ambulance companies to partially finance the newer, more needed, purchases. These are retained, just to qualify for more money. As you can tell, I have a thing about the terms "non-profit" and "not for profit" organizations that appear to be able to have the finest of carte blanche ..blank check equipment and manage to bill you large for it. I've seen the inner workings of such organizations and they aren't at all frugal in most of their operations. They are geared toward revenue generation ...yet can't for the life of them say "why"? So the budgets always expand ..the fund drives expand ..the organization expands ..the costs expand. ..and you pay $685 to go 12 blocks ...and they're broke ..always with thier hand out [Confused]
 
Messages
39,805
Location
Pottstown, PA
quote:
Call a few ambulance places, and make them compete for your money..... if you can afford to wait for the cheapest ride.
No, I think I'll open my own ...use Euclid based units and charge $12k a transport because I can handle any emergency ..and deserve to make everyone pay for it "just in case" there's a ELE that I can rescue people from before the next ice age. Strictly as a selfless public service. [I dont know]
 
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