Ely hospital, Tower ambulance near cooperative agreement

REGIONAL— Tower’s ambulance service and Ely Bloomenson Community Hospital are nearing final approval on an agreement that would give the hospital more medical and operational oversight of the ambulance service, while potentially helping the city-owned service reduce its costs for medical supplies and billing.
The 15-page agreement has slowly been in the works for the past couple years, ever since the hospital completed its study of a potential regional solution to ambulance service in the Ely, Tower, and Babbitt area. While the concept didn’t move forward at the time, city officials in Tower thought the idea had potential and reached out to continue talks with the hospital on greater collaboration.
Council member Kevin Norby, who assisted in the discussions over the agreement, said it offers some small steps towards greater collaboration that could benefit the hospital and the local ambulance services. “I think its’s a good opportunity to work more closely,” he said.
EBCH CEO Patti Banks shares that sentiment. “I don’t know that there are necessarily advantages for the hospital, but from the collaborative perspective and for patients or potential patients, it’s a good start to see how working together and pooling resources can strengthen the continuum of care.”
Among the potential benefits to Tower is a provision that would allow the Tower ambulance to acquire drugs and other medical supplies from hospital stocks in replacement of those items used for patients delivered to the hospital. The hospital would provide the medical supplies at “fair market value,” although details of that pricing had not been incorporated into the agreement as of this writing. Norby said he expected to meet with hospital officials in the coming days to get a better handle on the level of savings, if any.
The agreement also envisions hospital staff working with the city’s ambulance billing company to process the billing on behalf of the service. Norby said that could provide valuable experience to the hospital’s billing staff, which doesn’t currently handle ambulance billing. At this point, it’s unclear whether the hospital would handle all of the Tower ambulance’s billing, or only for those patients associated with Ely Bloomenson.
The agreement envisions that the hospital may eventually assume full responsibility for the ambulance billing, although Norby said that won’t happen immediately. Banks agreed. “We’re still trying to figure out how to work together in different ways to take care of our communities,” she said. “We letting Tower move forward at their pace.”
Under the agreement developed so far, the city would continue to maintain responsibility for staffing and scheduling ambulance personnel, administering payroll, as well as maintenance, operation, and replacement of ambulance vehicles and equipment. The city would continue to maintain its own ambulance director or supervisor, along with its own medical director.
City officials have suggested that the agreement might lead to additional inter-hospital transfers, which tend to be the most profitable runs for the ambulance service. But that’s not certain given that the hospital must first offer any transfers to the Ely ambulance before it can reach out to neighboring services.
Banks said she doesn’t expect the agreement to have any effect on the number of transfers.
Memo raised questions
As discussions on the agreement advanced, city officials in Tower did seek input from Jen. McDonough, the city’s interim ambulance supervisor in late June. In a seven-page memo to city officials, dated July 1, McDonough offered support for the stated goals but urged the city to consider a cost-benefit analysis before switching over its billing processes. “Our current billing company has consistently been an outstanding partner,” she wrote. “In addition to providing excellent service, they specialize in ambulance billing and maintain valuable relationships with EMS agencies throughout the region.”
McDonough also urged much more detail on some of the agreement’s provisions, such as what hospital “oversight” would entail. She also urged the city to establish some measurable performance expectations to determine whether the agreement was meeting desired goals. She also cautioned that the agreement would be unlikely to increase the number of inter-hospital transfers, something that some city officials are hoping to see to improve the ambulance services bottom line.
McDonough said her input seemed to anger some city officials, particularly Mayor Dave Setterberg. Barely a month later, Setterberg was pushing for her dismissal. After initially surviving that effort, McDonough opted to resign her service.