Washington County approves 13% AMR ambulance rate increase to slow financial shortfall

WASHINGTON COUNTY — The Washington County Board of Commissioners voted unanimously Thursday to approve a 13% out-of-cycle rate increase for AMR ambulance transports, effective July 1, 2025, after staff and AMR outlined cost pressures and potential system efficiencies.

Mira Samantalayi, director of Health and Human Services, introduced the county’s EMS briefing and said the county’s franchise-model EMS system depends largely on transport revenue. Adrienne Donner, a county public-health program supervisor who oversees the county’s EMS program, told the board AMR’s automatic ordinary increase for the year would be about 3.21%, and the company requested an additional increase beyond that. County staff brought the board the first year decision of a previously proposed multi-year schedule; the board was asked to decide on year one now and review the system before additional increases.

Rob McDonald, regional director for AMR in Oregon, described capital and operating costs and federal advocacy efforts for sustained EMS funding. McDonald said the requested increase is not “the solution to the actual problem” but would “do something that’s gonna slow the financial bleed being currently experienced,” and give time to pursue efficiencies across dispatch, hospital turnaround and triage.

County and AMR presenters highlighted system pressures that reduce ambulance availability, including long hospital transfer (turnaround) times that keep units out of service, dispatch accuracy, and the payer mix. McDonald explained that because government payers make up roughly three-quarters of transports in the county, AMR will not realize a dollar-for-dollar revenue increase for every rate hike; he estimated AMR would realize roughly a 6–8% increase in total revenue from this rate change given payer-class effects.

Commissioners pressed staff on timing and asked staff to return by October with progress on system-efficiency measures and a sustainability plan. The board moved, seconded and approved the 13% increase effective July 1, 2025, and directed staff and AMR to reconvene on efficiency metrics before October.

A county official noted that government-insured patients would not see an out-of-pocket cost increase because of payer rules; staff also said AMR has a compassionate‑care program and payment arrangements for patients with limited means.

OUTCOME: Motion to approve year‑1 13% rate increase effective July 1, 2025 — passed unanimously, 5–0. Staff and AMR will report back to the board before October with efficiency progress and potential next steps for years two and three.