Vermont EMS leaders warn reimbursement, workforce shortfalls threaten local ambulance coverage

Drew Hazleton, chief operations at Rescue Inc. and chair of the Vermont EMS Advisory Committee, told the House Health Care Committee on Feb. 4 that the committee is collecting statewide cost and workforce data and drafting a five-year plan for emergency medical services, and that current payment rules are reducing revenue for ambulance providers.

The committee contracted a consultant to assemble scattered local data because “EMS is done different in almost every community in Vermont,” Hazleton said, and the consultant’s report is due April 15. Hazleton said the advisory committee will begin a planning phase to produce a statewide EMS plan that is due to the legislature in December 2026.

Why it matters: Ambulance services operate on thin margins and rely on a mix of Medicare, Medicaid and private payments. Hazleton said a recent change in how Medicaid pays for “treatment without transport” — care provided on scene when no patient is moved — has resulted in payments at the lower hospital-to-hospital nonemergency transport rate rather than the higher emergency BLS rate, reducing expected reimbursement and leaving services short on revenue.

Hazleton describe…