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New Orleans EMS says revenue covers operations; seeks pay and more staff to reduce private-ambulance dependence
Summary
NOLA EMS told the budget committee it projects about $25 million in billing revenue for 2025, supplemented by a $7 million UPL receipt this year; it seeks pay increases and roughly 50 new positions to reclaim calls now handled by private contractor Acadian and reduce reliance on mutual aid.
New Orleans EMS briefed the budget committee on Oct. 15, saying the department is largely self-funded through patient billing and that increased ordinance billing rates and a recent Medicaid UPL payment improved revenue this year. EMS officials said they project roughly $25 million in billing revenue for 2025 and received about $7 million from a state UPL (Upper Payment Limit) adjustment this year.
Dr. Marino (medical director) and EMS Chief Salmeron said EMS currently relies on a contract with Acadian for roughly 25% of call volume (about 10 ambulances daily) and that bringing staff on city payroll would allow the department to bill for those runs directly. Chief Salmeron said that adding roughly 10 units per day (about 50 positions in the department's proposal) would return about $8 million in annual revenue now paid to contractors.
Why it matters: EMS said revenues fund its operations and that modest pay increases for paramedics would improve recruitment and retention, reduce overtime and ultimately allow the city to replace contracted ambulance services with its own units. That shift would increase net revenue available to the general fund.
Key points
- Revenue and payer mix: EMS reported an expected 2025 billing total near $25 million and a payer mix dominated by Medicaid (~40%), Medicare (~40%), private insurance (~20%) and about 1% VA; Medicaid patients typically generate lower billable returns by law.
- UPL and special-event revenue: The department said a one-time state UPL payment added about $7 million this year. Special-event details and convention contracts contribute roughly $650,000 annually.
- Staffing and pay: EMS leaders said they are staffing at roughly 64% with 18.75 vacancies at the time of testimony and proposed 50 additional positions as a phased staffing plan. Chief Salmeron and the finance team said the department seeks a wage increase to approximately $29'2.50 per hour for frontline positions to improve recruitment; officials proposed a phased approach that would restore capacity and reduce contracting costs.
- Contract dependency: Chief Salmeron said Acadian provides about 10 spare units daily and that reducing reliance on Acadian would both increase billed revenue and reduce the nearly $8 million in contracted expense.
Ending: EMS leaders said they will work with the administration and council on a phased recruitment and pay plan and emphasized that increasing city-staffed ambulance capacity is both a public-safety and revenue strategy.
