Emergency Medical Service providers across Pennsylvania have been struggling for years to fill the funding gap between what it costs every time an ambulance leaves the station and what they’re able to collect in reimbursements.

Medicare, Medicaid and private insurers often pay EMS providers less than the actual costs of delivering services. The payment is based on a reimbursement schedule set by the Centers for Medicare and Medicaid Services, it is not based on cost of medications, transportation, staff wages, etc.

Additionally, EMS providers are only able to bill patients if they’re transported to a hospital — so every time they’re called out but don’t take someone, ambulance services have to absorb the costs associated with those calls.

Locally, Harmony EMS has asked its 10 partner municipalities to support a half-mill tax increase in 2026 that would benefit its service. It could raise between $100,000 and $150,000 annually for the service.

Still, Harmony EMS director of operations Lynn Curl said even with that bump in revenue, it would not be enough to keep pace with the growing costs of providing emergency medical care.

On Monday, Dec. 8, Zelienople Borough Council approved its 2026 budget with the half-mill increase for Harmony EMS. In that municipality, it will generate about $14,500 annually. Other municipalities have either committed to enacting the tax bump or have pledged direct contributions.

Pennsylvania House Bill 1152 was referred to the Veterans Affairs & Emergency Preparedness committee in April. Its goal is to establish fair and direct reimbursement for mandated 911 services regardless of whether the EMS provider is in the patient’s insurance network or not.

EMS providers are required to provide service around the clock, every day, and are mandated to respond to every call that is made. They are not able to turn down a call because the reimbursement rate won’t be adequate or because there may be no payment at all.

Until state legislators figure out how to make EMS funding fair and manageable, local providers will likely continue to struggle to sustain their operations. In some areas, providers have trouble maintaining staffing levels because the funding situation is so dire and in others they must rely on grants to maintain crucial equipment.

Many EMS providers — Harmony included — offer subscriptions that enable them to raise funds and to offer patients protections from high out-of-pocket costs when their insurance doesn’t cover everything.

Consider buying a subscription or making a donation to your local EMS provider to ensure they’re able to continue serving our neighborhoods for years to come.

And look for the Butler Eagle to produce more reporting on the providers, the challenges they face and the solutions they find in January.

— KL