San Diego City Council Approves Significant Ambulance Fee Increase

News Summary

The San Diego City Council has unanimously approved an 18% increase in ambulance service fees for private insurers, set to be implemented over the next three years. The fee hikes, beginning July 1, will follow a scheduled increase of 7% in Fiscal Year 2026 and two subsequent 5% increases in Fiscal Years 2027 and 2028. This fee adjustment is part of a new model intended to alleviate operational costs while ensuring that patients covered by Medi-Cal or Medicare are exempt from these rises.

San Diego City Council Approves 18% Ambulance Fee Increase Over Three Years

The San Diego City Council has unanimously approved a significant increase in ambulance service fees for private insurers, starting July 1. The fee hikes will be implemented in stages over the next three years, culminating in an overall increase of 18%.

The fee structure will see a 7% increase for Fiscal Year 2026, followed by two 5% increases in Fiscal Years 2027 and 2028. These adjustments are part of the city’s newly adopted “alliance model” for emergency ground ambulance services for Fiscal Year 2024, which allows the city to charge and collect fees to help alleviate operational costs.

By the end of Fiscal Year 2028, the cumulative increase in ambulance transport rates will reach nearly 32.6%. For example, the cost for the highest level of care, known as ALS Emergency Transport Level 2, is expected to rise from the current fee of $3,151.32 to approximately $3,717.53.

Impact and Financial Context

This fee increase primarily affects those patients with private insurance, as roughly 11% of ambulance patients fall under this category. The city’s current rates for ambulance transport are lower than the countywide average of $3,283, with other jurisdictions charging over $4,000.

Officials anticipate that revenue generated from patient charges in the Emergency Medical Transport Program Fund will reach approximately $131.8 million in the upcoming fiscal year. In contrast, the estimated costs for Emergency Medical Services (EMS) will be around $391.9 million for Fiscal Year 2026.

Exemptions and Legal Protections

It is important to note that the fee increases will not apply to patients covered by Medi-Cal or Medicare. Additionally, a state law (AB 716) limits what can be charged to Medi-Cal beneficiaries and uninsured patients, offering them protection from these new rates.

Service Delivery and Future Considerations

The council’s decision to approve these fee increases comes in the context of ongoing discussions about the management of ambulance services in San Diego. Councilmember Marni von Wilpert has raised the possibility of the city assuming control of ambulance services by transitioning workers from private operators to city employees. This could represent a significant shift in how emergency medical services are delivered.

The approved fee increases coincide with rising hourly rates from the city’s private ambulance service providers, Falck USA and American Medical Response, making this a critical component of the city’s overall financial strategy.

Concerns and Future Planning

Some council members expressed concerns regarding the approval process for the fee increases, noting that it bypassed the usual committee discussions that typically accompany such significant financial changes. There is a continual effort to develop a mixed service approach where city ambulance staff would respond to lower-level emergencies, while private providers would manage advanced life support situations.

In conclusion, the San Diego City Council’s unanimous decision to increase ambulance service fees reflects a broader strategy to stabilize EMS funding and improve service delivery amidst rising operational costs. As these changes roll out, impacts on both service delivery and community health will be closely monitored.

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HERE Resources

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San Diego Leaders Consider In-House Ambulance Services

Additional Resources

• NBC San Diego
• Google Search: San Diego ambulance fee increase
• San Diego Union-Tribune
• Wikipedia: San Diego
• Times of San Diego
• Google News: San Diego ambulance service