Castle Rock Ambulance can continue

Castle Rock Hospital District is looking at ways to keep the ambulance service going.

“It’s an essential service. Kind of like the police department and fire department,” Todd Toolson, Castle Rock Hospital District CFO, said.

“We’re doing really well,” Toolson said.

He said they can continue to operate the service because they are still in the black. What it comes down to is whether they want to keep paying the loss to operate the ambulance service or look at other ways to use the money. They would like to expand CRHD services, such as having a weekend and evening clinics. Toolson said the money being lost every month operating Castle Rock Ambulance Service, which is about $35,000, doesn’t include any subsidies from the county or any overhead. He said they levy 3 mills for the hospital district, but most of it goes to operate the for-profit clinic.

“That’s what we’re using to keep the ambulance service running,” Toolson said. “Do we want to continue a losing service?”

For the district’s gross revenue as of June 20, 2019, the district had to write off about 48 percent. He said they work with the insurance companies, but it doesn’t seem to matter if they charge more, they will only receive so much from the insurance companies. For example: if they charge $2,000 per ambulance trip, they will only receive about $1,000.

“If we increase our fees, we don’t see much of a return on it,” he said.

The district showed having 14 percent in their bad debt category, which stems from uninsured patients. About 17 percent of all the patients they transport are uninsured.

On average, Castle Rock will charge between $1,000 and $1,470 per trip plus 31 cents per mile traveled. Toolson said it all depends on how far the ambulance has to travel, if they need basic or advanced life support.

“Our rates are a little below the national average,” Toolson said. “It costs a fortune to have a crew ready to go at a moments notice.” In order to get the fastest response times possible, they have to have at least one crew scheduled at all times and another crew on call. Toolson said when it’s in a rural area and has to be staffed all the time and the service doesn’t receive many calls, it gets expensive.

What’s out of their control is whether patients they transfer are insured, what kind of insurance they have or if they have no insurance. About 50 percent of the patients they transport are on Medicare.

“It pays horrible,” Toolson said.

About 10 percent are on Medicaid and that is even worse as far as coverage goes to pay for the transport. The only kind which pay what they should and account for 24 percent of their transports are commercial insurance companies. This would include Blue Cross/Blue Shield, Cigna and Aetna.

“If someone calls 911, we have to go,” Toolson said.

He said some people, which is a very small percentage, use the ambulance to take them to the hospital.

“They just utilize 911 as transportation,” he said. “It costs us a lot. Every time we take an ambulance out.”