Overview of the Ground Ambulance Cost Study and the Development of an Illustrative, Cost-Based Reimbursement Rate Schedule for Ground Ambulance Services
In accordance with Senate Bill 407, the New Hampshire Health Plan (NHHP) in conjunction with the NH Department of Safety and the NH Department of Insurance, is pleased to announce the launch of a comprehensive Ground Ambulance Cost and Rate Setting Study. This vital project, undertaken in collaboration with Public Consulting Group LLC (PCG), aims to analyze and understand the costs associated with providing ground ambulance services across the state of New Hampshire. The study’s findings will inform future legislation and policy decisions to ensure that ambulance services are adequately reimbursed and sustainably funded, ultimately benefiting both providers and patients.
Purpose of the Study
The Ground Ambulance Cost and Rate Setting Study is designed to gather detailed information on the financial landscape of ground ambulance services in New Hampshire. The study will:
- Assess Costs: Analyze the full range of costs associated with ground ambulance services, including pre-hospital care, operational expenses, and the cost of maintaining readiness to respond to emergencies.
- Evaluate Paid Claims: Examine the current ambulance fee schedule(s) and paid claims for all NH payors as well as identify additional viable billing codes (i.e. Treat and No-transport).
- Develop a Rate Schedule: Create an illustrative, statewide cost-based default rate schedule that can serve as a guideline for reimbursing nonparticipating ground ambulance providers, particularly for fully insured commercial payors.
- Support Legislation: Provide the data needed to support future legislation aimed at setting a universal default reimbursement rate for ground ambulance services, potentially prohibiting balance billing.
This study is essential for ensuring that New Hampshire’s ground ambulance providers are compensated fairly, enabling them to continue delivering high-quality, timely care to the communities they serve. The project is already underway and will be finished no later than December 31, 2024.
Reporting Requirement for Licensed EMS Units
Licensed EMS Units (also referred to as “ground ambulance providers”) are required to respond to PCG’s request for information and submit the necessary data in accordance with established timelines. The commissioner of the department of safety shall have authority to enforce this reporting requirement upon ground ambulance providers under the general supervision and specific enforcement authority conferred by RSA 153-A.
How Data will be Used
Data collected from Licensed EMS Units will be aggregated and analyzed, to be presented to stakeholders and legislators in a final report format – no individual EMS unit level data will be shared. For tabular data reporting, cells with a frequency (count) of <5 will be censored.
About Public Consulting Group (PCG)
Public Consulting Group (PCG) has been awarded the contract to conduct the Ground Ambulance Cost and Rate Setting Study. PCG is a nationally recognized consulting firm with extensive experience in healthcare, government, and public sector services. With a proven track record in data analysis, policy development, and financial consulting, PCG is well-equipped to carry out this critical project. Their expertise will ensure that the study is thorough, accurate, and completed on time, providing valuable insights for the state of New Hampshire.
Stay tuned for updates on the progress of this important study and thank you for your continued support in ensuring the sustainability and effectiveness of New Hampshire’s ground ambulance services.
| Date | Document |
|---|---|
| 09/23/24 | Open Forum |
| 08/29/24 | Open Forum |
| 08/26/24 | Instructions for Requesting the GADCS Instrument from CMS |
| 07/01/24 | RFP – NH Ground Ambulance Cost Study – Answers to Potential Bidders’ Questions – Updated 07/08/24 |
| 06/21/24 | RFP – NH Ground Ambulance Cost Study – Proposals Due 07/23/24 |