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Indianola approves 30% EMS fee increase to close reimbursement gap
Summary
After hearing that reimbursements lag costs, the council approved a 30% increase to EMS billing rates (oriented toward ALS2/max-transport) to help narrow an estimated reimbursement gap; staff said the increase will not fully close the deficit but will move rates toward statewide medians.
City leaders voted to raise the municipal EMS fee schedule to address a persistent reimbursement gap between the cost to provide ambulance services and the amounts paid by insurers and government payers.
Fire Chief Aaron Hurd presented data showing the city's EMS costs exceed reimbursements and noted statewide averages for high-acuity (ALS2) transports are roughly $1,300'$1,400 while Medicare/Medicaid reimbursements are significantly lower. Hurd said raising fees 10% would yield roughly $10,000 in additional revenue; his team recommended either a one-time 30% increase or a phased 15/10/5% increase over three years. "If we were to raise 30%, which is what I would recommend to bring us up in that median range for the State," he said.
Council debated the effect on uninsured and cash-pay patients and the equity of accelerating a single-year increase. One council member proposed the full 30% increase immediately to address urgent departmental needs; another favored a graduated approach. On a roll-call vote council approved the 30% increase (5-0). Staff said the increase will not fully cover EMS operating costs but will reduce the shortfall and that state advocacy (a CMS reimbursement study was cited) remains necessary for long-term stabilization.
Staff also provided operational context: the department makes multiple daily long transports to Des Moines and is replacing aging units; the council requested continued monitoring and periodic adjustments tied to cost trends.
