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Rockport officials defend new EMS service while urging patience on billing and revenues
Summary
After six months of running town EMS, staff outlined ambulance replacement timelines, billing lags, payer‑mix uncertainties and mutual‑aid revenue; officials said meaningful financial clarity will take 12–24 months and urged patience as receivables mature.
Rockport staff briefed the Select Board and Budget Committee on six months of the town’s new emergency medical services operation, describing the fleet, replacement planning, billing lag and revenue uncertainty.
Jason, describing operational details, said the EMS inventory includes a 2006 backup ambulance and a 2024 primary ambulance and noted long manufacturer lead times: "delivery for any ambulance service is about two and a half to three years for delivery after you order." He explained that agency practice is to stagger purchases so the fleet remains resilient, with a four‑to‑eight year effective in‑service cycle.
On finance, staff and committee members described a slow billing cadence. The town’s billing contractor, Comstar, was said to be on a nine‑month to multi‑year payment timeline for some claims; staff gave an example of earlier allowances where Medicare/Medicaid write‑offs totaled about $49,000 in a single quarter. "It's going to take 12, 18, 24 months before we really have a good idea of what our rolling receivables are going to be," staff said.
Officials highlighted mutual‑aid agreements and billing: Rockport has five signed mutual‑aid agreements in the county and standard mutual‑aid reimbursement was described as about $800 per run. Staff said per‑diem and volunteer personnel who live in town help cover second calls and reduce mutual‑aid payments.
Select Board members asked whether the town should always plan to operate two ambulances in rotation; staff said that while one ambulance was the original plan, a second inexpensive backup proved necessary given regional ambulance reliability issues and recent crashes and maintenance outages elsewhere. Officials cautioned that the EMS program is not a profit center but that mutual‑aid revenue and transport fees help offset costs.
Because payer mix matters (the town has a high share of Medicare patients), staff requested time to collect a full year of data before offering firm budget projections and recommended the Budget Committee receive payer‑mix reports as part of FY27 preparation.
