GAO Publishes Final Report on Rural EMS Payment Problems

A long-awaited study of rural EMS payment issues reached the U.S. Congress this week, sparking renewed debate over measures to preserve rural access to EMS services for Medicare beneficiaries.

Entitled "Medicare Payments Can Be Better Targeted to Trips in Less Densely Populated Rural Areas," the GAO report found that "The modest variation in Medicare payments to ambulance providers that serve rural counties probably does not fully reflect their differences in costs because the key factor affecting provider costs---the number of trips---varies widely across rural counties." GAO further found that "…trip volume is a better indicator of provider's cost per trip than is trip length." GAO recommended executive action to "…better target the rural payment adjustment to trips provided in rural counties…by adjusting the base rates…"

Almost three years in the making, GAO's report arrives at a crucial moment in Medicare politics. House and Senate conferees are working to merge two different versions of a Medicare package containing a prescription drug benefit for the elderly and a number of provider relief measures. Sources say that up to $400 million could be available to supplement rural EMS payments, but the conferees have not yet agrees on how to target the funds.

Urge your friends in Congress to read the GAO report, and to enact a rural payment modifier based on population density per service area. For background on Rural EMS Advocate's proposal, click REMS Advocate's Agenda for Medicare Payment Reform.

To download a copy of GAO's final report and recommendations, click GAO-03-986. To e-mail a copy to your Senators and House Members, click Congressional Links for access to Thomas, the website of the United States Congress. (Please be aware that regular USPS surface and air mail to Congressional offices is subject to inspection and lengthy delays.)