MedStar board members voted to approve a balanced budget with $65 million in anticipated revenue Dec. 6 — without any funding from the city of Fort Worth.
Usually, annual budgets are passed in September. MedStar held off on passing its own budget while waiting for Fort Worth’s final decision on whether to subsidize MedStar’s operations in the new year. The EMS provider had requested $4.2 million in the summer, citing a fraught financial situation amid declining reimbursements from Medicare and Medicaid, rising costs and low collection rates.
Some of the most abysmal collection rates came from incarcerated people at the Tarrant County Corrections Center. A Fort Worth Report investigation found the average payment MedStar collected from uninsured patients in the jail last year was $2.36. In all, MedStar is owed about $2.6 million from jail transports in 2022.
“This whole conversation about the budget shortfall, it really comes down to uncompensated medical care we’re providing in the community,” MedStar CEO Ken Simpson said. “And that’s what EMS providers across the country are dealing with. We are truly a safety net provider.”
While Fort Worth City Council approved setting aside transitional funding for MedStar in September, the council members held off actually allocating the funds while the EMS provider had more conversations with JPS Health Network about potential reimbursements for jail transports. Hospital districts like JPS have a legal responsibility to provide care for county residents who can’t pay.
Now, JPS and MedStar are nearing a contract that would reimburse MedStar for county jail transports in the future. MedStar also received confirmation in November that the city of Fort Worth will reimburse it for less-frequent services to the city jail.
Those revenue streams, combined with the elimination of some unfilled positions, allowed the board to pass a balanced budget without funding from Fort Worth, Simpson said.
“I really feel like it’s a pretty good budget,” he said. “It achieves the objective of making sure that we’re able to add more ambulances and resources to the street, and meet the call volume increases. It gets us most of what we were looking for, in the short term.”
Valerie Washington, assistant city manager, said the city is excited that MedStar was able to dig into its finances and shore up its budget to the point that transitional funding isn’t needed.
“We want to and will continue to work closely with MedStar on reviewing their financials on a monthly basis to ensure that we agree with their assessment,” she said. “Because we don’t want to get to a situation where we’re having the [funding] conversation again in a few months.”
The funding initially set aside for MedStar will remain in the nondepartmental fund for the time being, Washington said. There won’t be any need for the City Council to take action unless it wants to allocate the funds elsewhere.
Simpson said passing the 2024 budget also gives a consultant team hired by the city of Fort Worth time to complete its study and make recommendations about the future of EMS services in the city. Fort Worth has relied on MedStar for emergency medical services since 1986, and the provider currently serves 13 municipalities in Tarrant County.
“It’ll give us the opportunity to build out what the future looks like going forward,” Simpson said. “And it gets us further down the road toward making those improvements.”
At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here. Emily Wolf is a government accountability reporter for the Fort Worth Report. Contact her at emily.wolf@fortworthreport.org or via Twitter.
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