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Scotland County EMS presents options as officials weigh privatization and fee changes
Summary
EMS leaders outlined staffing, rising revenues and billing challenges while commissioners requested more data on Medicaid billing and event‑coverage fees; a consultant noted national billing pressures and payer‑rate variability.
Scotland County EMS Director Robert Sampson and consultant Kim Stanley presented an operational review July 6 that outlined staffing, revenue history and options as the county considers whether to retain EMS as a county service or pursue third‑party providers.
Sampson said the department employs 28 full‑time staff (not including the director and one manager) and about 10–12 part‑time employees. He told commissioners the service wants to remain a county operation: "the staff is present tonight and are dedicated to Scotland County and want EMS to remain a county service."
Consultant Kim Stanley summarized national billing pressures, noting a federal study that showed ambulances operating with deficits and outlining the effects of payer mix. On reimbursement she told the board that billing entity matters for rate differences: "the rates are $73 or $123," referring to the lower and higher reimbursement scenarios depending on billing and payer arrangements.
Commissioners asked specific questions about Medicaid-managed care billing and whether third‑party providers could achieve better Medicaid reimbursement. Ms. Stanley said she would provide detailed Medicaid MCO billing figures to the board. Director Sampson said revenues have increased recently and that the department recommended fee increases for FY2027 while remaining lower than neighboring counties.
The county will continue to collect RFP responses about possible privatization and asked EMS leadership to return with more detailed payer and event‑coverage fee data for the next meeting.
