Sierra Vista Herald

March 7, 2016

by Christine Steele

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BISBEE — Jim Dickson, CEO of Copper Queen Community Hospital, said the city of Bisbee should not be counting on revenues from ambulance transfers to bail them out of their financial crisis.

At Tuesday night’s Bisbee City Council meeting, Bisbee resident Susan Blackford presented a petition asking the city to consider purchasing one or more ambulances, new or newer, to increase revenue for the city, saying ambulance transfers are a “proven money-maker.”  Dickson, however, disagrees.

“It is unnecessary at this time to add ambulances because we have a temporary increase in transfers,” he said. “We are experiencing an inordinate number of transfers due to the closure of the Douglas hospital, but once we open our standalone Emergency Department in Douglas in September or November, that will drop.”

Officials broke ground on the new $6.5 million facility in November 2015 and it is expected to be completed this fall.

Ambulance transfers, also called interfacility transfers, occur when a patient has to be transported from one hospital to another for a higher level of care. Agencies doing the transfer are paid a set rate for the transfer — $1,300 to transfer someone to Sierra Vista, and $2,400 to for transfers to Tucson hospitals. The money is seen as a boon to the agency.

Bisbee started seeing more requests for interfacility transfers in August after Cochise Regional Hospital in Douglas closed after losing its Medicare funding following a report by the Arizona Department of Human Services detailing multiple violations.

That’s when the request for transfers jumped and since August, the city has gone from an average of about 30 a month in the months prior to August to an average of 86 a month from August 2015 through the end of January 2016. Back in August, the city of Bisbee also entered into an Intergovernmental Agreement with the Palominas Fire District to partner up and share the transfers and staffing for them and split the proceeds.

But Dickson said counting on that continued revenue is a “pipe dream” for the city.

“This should not be looked at as an additional source of revenue since it is going to diminish markedly in September or November,” he said. “It would not be sound economic planning to count on a temporary revenue source.”

He said once the new Douglas facility is complete, those additional transfers will disappear because if a patient can’t be attended to at the new Douglas facility they will need to be transferred from there to either Canyon Vista Hospital in Sierra Vista or Tucson Medical Center and those transfers will be handled by the Douglas Fire Department.

Dickson also said the current Medicare reimbursement system gives an additional 10 to 15 percent to rural ambulance providers but he anticipates that will be cut.

“We fully expect this to disappear,” he said. “Under the Affordable Care Act that will be a reduction so they are facing a reduction in both volume and reimbursement.”

Bisbee is also facing another possible financial squeeze as Arizona Ambulance, a private, for-profit ambulance company, has applied for an expanded Certificate of Necessity from the Arizona Department of Health to give them equal status in interfacility transfers, instead of just a backup Certificate of Necessity, which is what it has now, which will cut into the transfers that Bisbee has been doing in partnership with Palominas.

There was a two-day hearing last week in Phoenix and the decision now rests in the hands of an administrative law judge. The judge gave counsel for both sides one month to submit their closing briefs and a decision will be made following that.

If Arizona Ambulance is granted equal status, that will give the hospital a choice of who to call for transfers. But Dickson said the city has no reason to worry as he still plans to use Bisbee Fire Department first and Arizona Ambulance as a backup, in line with a 2011 agreement.

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