Title
A Resolution Of The City Commission Of The City Of Hollywood, Florida, Authorizing The Appropriate City Officials To Execute An Agreement With Change Healthcare Technology Enabled Services, LLC For Emergency Medical Billing Services, In Accordance With Section 38.41(C)(11)(A) Of The Procurement Code. (Software/ Hardware Exemption)
Strategic Plan Focus
Public Safety
Body
Staff Recommends: Approval of the attached Resolution.
Explanation:
Fire Rescue has been providing emergency ambulance treatment and transport services to the citizens of Hollywood since the late 1970’s. Since then, the nature and scope of these services has evolved from simple Basic Life Support medical care and transport to today’s Advanced Life Support medical care including trauma, cardiac arrest, overdose, OBGYN and complex pediatric medical protocols. Transport services are ruled under strict State and Federal laws, regulations, and medical oversight. These medical and transport services are provided to all residents and visitors, regardless of medical insurance status or ability to afford the cost of the services.
As the national EMS information collection standards evolved throughout the years, all EMS agencies have been mandated to standardize their collection and reporting methods to meet the requirements of the national EMS database known as NEMSIS, the National EMS Information System. On the State level, the Florida Prehospital EMS Tracking and Reporting System (“EMSTARS”) program was created to provide for the collection and transmission of electronic incident level data from EMS providers to The Florida Department of Health. EMS providers who participate in data exchange with the Florida Department of Health and the EMSTARS database must adhere to all the policies and reporting requirements stipulated in subsection 64J-1.014(1), F.A.C.
Historically, Fire Rescue has experienced a marked increase in call volumes and demand for EMS services and transports. The original transport billing methods and processes were performed by the Memorial Healthcare System and by the early 2000’s, the City decided to rely on the services of billing and collection vendors due to the large number of transactions and complexities of Medicare, Medicaid, Private Insurance and Self Pay methodologies.
Fire Rescue had utilized the services of Advanced Data Processing Inc. (“ADPI”) for emergency medical transport billing and collection services from December 31, 2006 through December 31, 2021. Additionally, Fire Rescue had agreed to have ADPI provide consulting services for Revenue Recognition and to enroll in the Florida EMS Public Emergency Medical Transports (“PEMT”) Medicaid program and provide ongoing consulting/costing services for both the Florida Certified Public Expenditures PEMT and the Intergovernmental Transfer PEMT which includes Medicaid Managed Care Organizations (“MCO”) transport revenue programs.
As the agreement with ADPI was set to expire, Fire Rescue performed market research and determined that for efficiency and operational purposes it was in the best interest to piggyback the terms of the City of Lauderhill’s Master Agreement with Change Healthcare Technology Enabled Services, LLC for handling accounts for ambulance services, collection efforts, data capturing, reporting systems and dedicated technology support. The agreement between the City and Change Healthcare Technology Enabled Services, LLC was for a three-year term beginning on January 1, 2022.
With the assistance of the Office of Procurement and Contract Compliance and the City Attorney’s Office, it was determined that Fire Rescue could continue with the services with Change Healthcare Technology Enabled Services in accordance with section 38.41 (C)(11)(a) of the Procurement Code.
(a) Software and hardware subscriptions, licensing, and maintenance with the company from which the software and hardware was purchased, as set forth in sections 38.43 or 38.44, or its authorized representative.
The agreement being pursued with Change Healthcare Technology Enabled Services directly impacts the software used by Fire Rescue for all incident reporting and the patient care reporting for all transports and non-transports via ESO Solutions software. It is imperative for the software to remain in place to allow the department to conduct normal daily operations.
The Change Healthcare Technology Enabled Services agreement also provides our officers with Getac rugged laptops for use in the field to document patient care and fire incident reporting. The 22 Getac units in use are covered under warranty and will need continued coverage for existing and future machines for personnel to use to conduct daily business.
In summary, our contract with Change Healthcare Technology Enabled Services allows for flexibility to address our needs as a patient transporting agency. The hardware deployed such as the Getac rugged laptop can withstand the rigors of first responder work and prehospital care. At times, our crews are working with patients on streets or sidewalks, as well as dealing with combative patients that knock the computers out of the report writer’s hands. The Getac’s durability decreases the need for repairs, hence, a decrease in shipping costs. Additionally, Getac customer service sends parts that are easy to replace. The contract with Change Healthcare Technology Enabled Services has also assigned a technical support person to Fire Rescue who maintains, updates, and repairs Getac laptops in addition to other duties which far surpasses any support from the previous billing company.
In terms of software, Fire Rescue were able to purchase ESO Electronic Health Record, which enabled the Department to be up to par with surrounding agencies and achieve compliance to Florida State EMSTARS standards. ESO also produced a Fire Incident Reporting solution that resulted in a significant improvement over the previous records management system. The enhanced reporting has allowed the Department to extract data in more creative ways and has aided in the attainment of several lucrative grants.
Lastly, the customer service from Change Healthcare Technology Enabled Services assists administrative staff with billing and other records request fulfillment via an automated platform called Chart Swap. Their customer service represents a marked improvement over the previous billing company. All these enhancements are paid for by a lower percentage of transport collections, and an increase in cost recovery from the PEMT and MCO programs.
Fiscal Impact:
Based on prior year collections, the estimated annual revenue is $4.5 million. Revenue related to EMS billing will be deposited into account number 001.215001.34200.342610.000000.000.000.
The City will be responsible for paying:
1) Billing fee: 5.5% plus $9.00 per Medicaid account.
2) Hardware (22 Getac rugged laptops plus Verizon Aircards and warranty) and ESO software (EHR and NFIR with associated interfaces): 3.65%
3) Dedicated resource for hardware issues: 2.3%
4) Total fee for all services: 11.45% of net collections plus $9.00 per Medicaid account.
• PEMT: 9.6% annually
• MCO: No fee
The estimated cost to the City for these services is $419,300.
A portion of the funding for the fees related to this agreement is available in the FY 2025 Operating Budget in account number 001.215001.52200.631170.000000.000.000, and will be budgeted in subsequent fiscal years’ operating budgets subject to approval and adoption by the City Commission.
Recommended for inclusion on the agenda by:
James Russo, Fire Chief
Chris O’Brien, Director of Public Safety