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City EMS reports revenue gain per trip, ongoing reliance on Medicare/Medicaid; community paramedic program underway
Summary
Laconia’s EMS leadership told the council the department’s average revenue per transport rose to about $517; roughly 75–80% of payer mix is Medicare and Medicaid. The city has launched a federally funded community paramedic program that has completed about 39 encounters in its first month.
Deputy Chief Scott Lewandowski told the Laconia City Council on Monday that the city’s emergency medical services have seen an increase in average revenue per transport and are running a newly launched community paramedic program funded by a federal grant.
Lewandowski, who oversees EMS operations, said the department’s average revenue per trip is about $517 following a rate increase that took effect in June 2024. He said the typical charge for a basic life support (BLS) trip would be about $1,313, while Medicare and Medicaid reimburse roughly $450 for that service — a substantial discount from billed charges. "It's averaging about just over 500, 500 and 17," Lewandowski said of revenue per trip.
The deputy chief said payer mix remains heavily weighted to Medicare and Medicaid, representing about 75 to 80 percent of transports, while commercial insurance (Anthem, Cigna and similar carriers) makes up roughly 9 percent. Lewandowski told councilors the ambulance service bills through a third-party firm, QuickMed Claims, and that he has seen a slight shift toward private insurance payers in recent months.
Residents asked several questions about reimbursement rates, uncompensated care and the status of new equipment. Lewandowski said the department is awaiting two new ambulances that have been delayed by workforce constraints at manufacturers; one may arrive late this year or early next year. On uncompensated care, he said applications for hardship waivers were rare — two or three granted in the last year.
Lewandowski also briefed councilors on a community paramedic program funded through a federal grant administered by the Partnership for Public Health. The city’s community paramedic — a paramedic performing non-transport patient encounters — began work approximately one month ago and had completed about 39 encounters at the time of the meeting. "She's been treating patients now for about a month. She's doing a fantastic job," Lewandowski said. He said the community paramedic’s salary and vehicle are covered by the grant and are not part of the EMS operating budget presented to council.
Chief Joubert introduced Deputy Chief Lewandowski and said Lewandowski handles EMS finances and operations. Councilors asked for a follow-up update on the community paramedic program during upcoming budget presentations; Chief Joubert said he would include an update in the department’s budget presentation.
The EMS presentation also covered revenue and loss accounting. Lewandowski explained that billed charges typically exceed actual collections because Medicare and Medicaid reimburse at fixed rates lower than billed amounts; he said the department’s loss numbers reflect that gap and rising supply costs such as defibrillator pads and oxygen supplies.
