Declining Medicare reimbursements and a growing population of senior adults have combined to create a $1.4 million ambulance service deficit that Fire Chief Keith Woodley expects to only deepen in the months and years to come.




Woodley told the Ashland City Council in a workshop on Monday that Medicare provides only 42 percent reimbursement for the costs of ambulance service, an arrangement that has created financial problems for many ambulance providers across the United States.




Congress in 2002 put reimbursement on a declining scale that leveled out last year. Income has declined in large part because Medicare customers now account for 63 percent of ambulance trips in the city, according to Woodley.




"There's no way out of this right now, that I can see," said Councilman David Chapman. "We have an aging population, so guess what? It's a service we're going to have to provide and subsidize."




Woodley proposed minor fixes that could raise about $100,000 a year in new income.




The city charges $850 to transport a patient, but is reimbursed only $357 by Medicare.




Woodley's written report to the council stated the Government Accountability Office has found that nationally, Medicare reimbursement is about 6 percent below costs for ambulance service. Ambulance providers have been lobbying Congress for an increase of 5 percent, many ambulance services in other parts of the country are also supported, at least in part, by tax revenues.




The presentation was a beginning of the discussion that will develop as the city budget committee addresses the matter. At this time, Woodley added, none of the options are really viable and there's no direction yet from the council.