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Brentwood panel weighs Fremont EMS takeover amid cost, cash‑flow concerns
Summary
At a July 29 subcommittee meeting, Brentwood officials and billing consultant MBS reviewed revenue estimates for a proposal for Brentwood to provide EMS for Fremont. Members pressed on payer mix, first‑year cash timing, and whether a proposed $90,000 readiness fee fairly covers added costs.
Brentwood officials and a billing consultant met July 29 to examine whether Brentwood should provide emergency medical services to neighboring Fremont and how to structure payment and billing. Jeff of MBS presented Brentwood data and cautioned that payer mix — Medicare, Medicaid, commercial insurance and uninsured patients — drives how much a community will actually collect.
“Your payment percentage was 45.25,” Jeff said when summarizing Brentwood’s 2025 collections, offering a baseline the subcommittee could use to model Fremont revenues. Members pressed that the slow cash‑flow typical of ambulance billing — an insurance phase of 30–180 days followed by months of patient‑balance work — creates a runout that will depress first‑year receipts.
The committee debated two contracting approaches: have Brentwood retain patient revenues and charge Fremont a readiness/contract fee, or have Fremont collect revenues and pay Brentwood a fixed amount. Selectman (speaker 1) emphasized taxpayer protection, saying Brentwood “cannot take a risk to the taxpayers” if collections fall short. Several members urged an RFP to obtain market pricing and comparable contracts before finalizing numbers.
Next steps: the subcommittee agreed to pursue an RFP and reconvene after more complete data are available; a future meeting time of 3:00 p.m. was discussed but left flexible.
