Cost of Spokane ambulance rides set to jump 28%

The starting cost of an ambulance ride in the city of Spokane will increase 28% under a new one-year agreement approved on Thursday.

Though they bemoaned the sizable rate hike and timing of the proposal, members of the council reluctantly signed off on a new one-year contract with the city’s ambulance provider, American Medical Response.

Although the Spokane Fire Department responds to medical calls, the city relies on AMR to provide emergency medical transportation.

An ambulance ride in the city of Spokane currently starts at a base rate of $757, for either basic life support or advanced life support service. AMR charges a per-mile rate of $22.88 on top of that base rate.

Under the five-year contract proposed by the city administration earlier this month, AMR would raise its rates to a base of $975, an increase of about 28%. Initially, AMR had requested that the city raise its base rates to $1,207.

The administration had recommended the council approve the higher rate for five years to ensure stability of the service, but the council opted Monday to extend it only for one year while it digs into the issue further.

The vote was forced Thursday in large part due to the fact that the city’s current five-year contract with AMR expires at the end of May. If it allowed the contract with the city to expire, AMR could continue to provide service in Spokane, but its rates would not be set by contract with the city and could surge higher than the current rates, according to City Administrator Wes Crago.

AMR and the city administration argued that the increased rates were within reason because the company has faced increased costs due to the COVID-19 pandemic and a new labor contract that will raise employee pay 11% over three years.

Particularly, officials cited increased cleaning requirements that could slow response times during the pandemic, as well as the potential for a patient surge that to date has not occurred.

The company and city officials also contended that the vast majority of Spokane residents wouldn’t be directly impacted by the rate increase because they are either covered by a private insurance that negotiates rates directly with AMR or by a government program like Medicare or Medicaid, which set their own reimbursement rates.

In justifying the new rate, officials pointed out the city of Spokane would fare well in comparison to other cities in the Pacific Northwest. It pays a base rate less than one-third of Tacoma’s, and $100 less than the unincorporated parts of Spokane County.

But members of the City Council balked, asking why the city should give AMR a raise when it has the option to extend the contract for five years with an increase tied only to the rate of inflation.

Councilwoman Betsy Wilkerson thanked Spokane Fire Chief Brian Schaeffer, who last week took the blame for the late introduction of the proposal, but said “we all need to do a better job.”

Councilman Michael Cathcart was the only member to vote against the one-year contract, expressing concern about a lack of data to base his decision on, among other frustrations. He described the proposal as “basically a 28% fee increase on those that are uninsured.”

“I really hope we can have a more robust discussion around this as we talk about a potential five-year contract,” Cathcart said.

As it considers the future of EMS in Spokane, Councilwoman Kate Burke said the city should consider providing the service through its own fire department, which Schaeffer and other city leaders have traditionally hesitated to explore.

Schaeffer said the city’s labor costs would be greater than that of a private provider, and it would also have to spend money to purchase the necessary equipment to provide its own medical transportation service.