Study Explores Integrating Ambulance, Island Medical Center To Generate Funds
By Karen Gould

A study is being conducted to determine if integrating the Mackinac Island Medical Center with ambulance operations on the Island will generate more money. Currently, the City of Mackinac Island owns the ambulance, but contracts with Allied EMS Systems, Inc. of Petoskey to operate the ambulance service. The city budgets $30,000 a year to subsidize the ambulance operation, which includes wages and benefits to staff it, but the actual subsidy, said Allied’s executive director, Dave Slifka, is determined by the number of ambulance runs made during the year. The more runs the ambulance makes, he said, the less funding the city needs to contribute.

Rod Nelson, the chief executive officer at Mackinac Straits Hospital in St. Ignace, which manages the Mackinac Island Medical Center, said a new arrangement whereby the ambulance service would be operated by the medical center might be able to generate more money for the facility and reduce the burden on the city.

He envisions the Medical Center leasing the ambulance from the city and then contracting with Allied to operate the service for the Medical Center, instead of the city. The Medical Center, he reasons, could be eligible for higher Medicare reimbursements than the city.

To find out if such a plan would work, the hospital has hired Gary Wingrove of Wingrove Consulting in Buffalo, Minnesota. Aarron Reinert, a paramedic, will be working on the Island study for Wingrove.

To be successful in generating more money, hospital officials know that the Medical Center must be awarded a special Medicare designation for ambulance service. This would enable the facility to receive Medicare cost-based reimbursement, said Mr. Wingrove, which could be based on the actual operating cost of the Mackinac Island Medical Center. One of his jobs will be to seek that designation.

“It would be advantageous for the city for the ambulance depreciation to be under the hospital and replacement under the hospital,” said Mr. Wingrove.

Additionally, Mr. Wingrove said the study will take into consideration the cost of running the ambulance if the costbase reimbursement status does not come through. The study also will include general recommendations regarding the service.

Mr. Nelson said the study will look for ways to have nonresidents help support the service. He said now about 600 people support the Island’s infrastructure, while visitors enjoy the benefits of the taxes those 600 people are paying.

Another part of the study will include the number of patients transported to St. Ignace and a review of the cost for those transports. Depending on circumstances, this can include travel by boat, plane, or with the U.S. Coast Guard.

Mr. Wingrove, who also works for an ambulance company in Rochester, Minnesota, estimates the study should be completed by the end of February, depending on the complexity of the project and how quickly Medicare responds to the cost-based reimbursement status request.

The ambulance made 218 runs in 2005, mostly from May through October during the tourist season, but not all the runs brought patients back to the Medical Center. Only 168 runs returned with patients, said Clinic Coordinator Kay Hoppenrath, the others involved patients refusing transportation or not needing transportation, and patients being transferred directly to the mainland for further care.