County EMS consultants propose rate increases to narrow revenue gap

Deputy Chief Justin Bridal and Kim Stanley of EMS Management Consultants briefed the board on EMS billing performance and a recommended user‑fee increase intended to improve cost recovery.

Stanley said Cabarrus County’s EMS program bills a large gross charge pool but collects a smaller net share because of contractual allowances and payer mix. The county’s internal collection work (including debt set‑off and garnishments) produced a collection percentage higher than many peers — roughly 76% of legally collectable amounts — but operating expenses still outstrip reimbursements. The consultants presented a range of rate options and projected that, if the board approved proposed increases and the county followed the consultant’s plan, EMS revenue could rise from roughly $11.3 million to about $12.8 million for the fiscal year.

Stanley and Bridal emphasized the policy and market constraints: Medicare/Medicaid contractual allowances cap what the county can collect from those payers, so proposed increases are expected mainly to yield higher reimbursement from commercial insurance and third‑party payers. Commissioners asked about possible diminishing returns if rates rise too far; consultants said there is a correlation between higher billed charges and higher reimbursements but warned of limits and urged a measured approach. They also described potential state‑level legislative tools (example: requiring insurers to pay a percent of Medicare) under consideration elsewhere.

No action was taken; staff said the county would bring a rate proposal to a future work session for formal consideration and potential inclusion in the FY27 budget process.