By Austin De Dios
oregonlive.com
CLACKAMAS COUNTY, Ore. 鈥� The cost of calling an ambulance in is about to more than double.
Those changes come after the county renegotiated its contract with emergency medical giant American Medical Response, which also serves Washington and counties. The Clackamas County Board of Commissioners approved the skyrocketing prices July 31 as part of a new 10-year contract with the ambulance provider.
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鈥淎mbulance response times have been a region-wide struggle over the past few years, but I am pleased that recently here in Clackamas County we have been seeing positive trends,鈥� Chair Craig Roberts said in a statement at the time. 鈥淭his new contract with AMR will help ensure that those positive trends continue and that AMR meets clinical performance metrics in addition to response time requirements.鈥�
Under the new agreement, base prices for an ambulance pickup have jumped from $1,676 to $2,245, and that cost will rise again in November to $3,480, the contract shows. AMR also charges for the miles it takes to transport someone to the hospital. Those rates will climb from $35.10 to $72.90 in November, records show.
The provider is also allowed to charge a base fee if a patient calls for an ambulance, but is treated on site and not ultimately transported to a hospital, according to the contract.
AMR Northwest said in a statement that the price hikes are a result of rising costs for paramedics, fuel, vehicles and medical equipment. Commissioners said the company told them that prices in the county were well below the market average and had not been keeping up with inflation.
鈥淭o remain sustainable and ensure that crews, vehicles, and equipment are available when Clackamas County need them most, AMR must balance affordability for patients with the financial realities of operating an emergency service that is available any hour of the day,鈥� the company said in a statement.
The board voted unanimously to pass the new 鈥減erformance-based鈥� contract. Commissioner Martha Schrader applauded the work of the county to come to an agreement with AMR in the July meeting.
鈥淚鈥檓 glad that we brought it to fruition, I鈥檓 glad we have good partnerships,鈥� Schrader said. 鈥淚 will enthusiastically vote yes to see this finished up for the time being.鈥�
But some board members told The Oregonian /OregonLive that they had reservations about the contract and the cost to county residents and visitors who have a medical emergency.
The county and AMR have argued that the increased prices will be covered by insurance, saying that the majority of the county鈥檚 residents are insured. But costs will depend on an individual鈥檚 insurance plans, deductibles and co-pays.
鈥淭hat was a huge concern, not just for me but I think the entire board, when we saw the increased cost,鈥� Commissioner Ben West said. 鈥淢ost people will see their insurance cover that cost, but there are those in our community that will see an additional expense if they have to call an ambulance.鈥�
The cost of calling an ambulance in Clackamas County now far outpaces the price in Washington and Multnomah counties. Transport in an advanced life support ambulance in Washington County costs $1,949 plus $31.18 per mile it takes to get to a hospital.
That rate is $1,744 and $35.91 per mile in Multnomah County, which has a with AMR and the ambulance provider鈥檚 sluggish response times.
West, who is a nurse, urged people in the county not to let the price hikes make them feel like they need to transport themselves to a hospital, potentially putting people in greater danger.
AMR is offering a 鈥淐ompassionate Care Program鈥� that officials said provides financial assistance to those who need it. The county also launched its nurse navigation program last year, which can transfer people calling 911 with non-emergency injuries or illness to a nurse who can assess where the person should seek medical care.
Clackamas County has had its own struggles with AMR鈥檚 response times. In 2023, the county put AMR on a performance improvement plan for failing to meet requirements. Response time requirements differ depending on the type of emergency and region the call comes from. In urban areas, an ambulance is expected to respond to high acuity calls within eight minutes 90% of the time. The county said AMR has been in compliance with that and other standards for five months.
Commissioner Paul Savas had pushed to increase fines to AMR for slow response times in step with the increase in patient costs, he told The Oregonian /OregonLive. He said that the fines did increase, but not to the level he had asked for.
鈥淚 didn鈥檛 get everything I wanted,鈥� Savas said. 鈥淚 pushed hard and played hard ball to get the best out of this as I could. But I think everyone wanted to get this across the finish line.鈥�
The other problem, Savas and West said, is that there were no other options. Both commissioners said that AMR was the only real provider able to tackle the needs of the county. Other counties have struggled with the same problem.
鈥淚t鈥檚 a monopoly of sorts,鈥� Savas said.
Multnomah and Washington counties鈥� contracts with AMR will expire in 2028, but officials said each county has clauses in those agreements that allow AMR to increase patient rates incrementally each year and submit requests to the counties if they want to make larger rate increases.
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