The chart below shows the allocation of charges across the following categories over the past 12 years:
- Transport & Standby Charges - transports, treatment no transport charges, events, and facility charges
- Revenue – actual receipts
- Contractual Adjustments – difference between fee schedule and the allowable fee schedule for Medicare, Medicaid, VA, Tricare, and any HMO plan
- Other Adjustments - bad debt reversals, jail write-offs, hardship applications, etc.
- Bad Debt Write-off – as approved by the BCC
The 2019/2020 data is as of August 31, 2020. The Bad Debt Write-Off and Accounts Receivable columns include the allocation based on the approximate $9.7 million requested in this agenda item.
Fiscal Year |
Transport & Standby Charges |
Revenue |
% of Total Charges |
Contractual Adjustments |
% of Total Changes |
Other Adjustments |
Total Bad Debt Write Off |
% of Total Charges |
Accounts Receivable |
2007/2008 |
20,241,031 |
9,024,324 |
45% |
6,588,981 |
33% |
(216,602) |
4,844,328 |
24% |
0 |
2008/2009 |
20,100,678 |
9,252,816 |
46% |
6,365,328 |
32% |
(219,112) |
4,701,646 |
23% |
0 |
2009/2010 |
20,166,624 |
9,362,589 |
46% |
6,403,097 |
32% |
(265,072) |
4,666,010 |
23% |
0 |
2010/2011 |
20,646,220 |
9,831,671 |
48% |
6,921,001 |
34% |
(216,679) |
4,110,227 |
20% |
0 |
2011/2012 |
24,081,659 |
10,333,055 |
43% |
8,721,430 |
36% |
(152,852) |
5,180,026 |
22% |
0 |
2012/2013 |
25,814,884 |
11,048,463 |
43% |
9,813,004 |
38% |
(150,434) |
5,103,851 |
20% |
0 |
2013/2014 |
26,928,706 |
11,826,072 |
44% |
10,174,297 |
38% |
(160,285) |
5,088,622 |
19% |
0 |
2014/2015 |
27,509,180 |
12,009,124 |
44% |
10,261,996 |
37% |
(203,802) |
5,441,862 |
20% |
0 |
2015/2016 |
27,878,748 |
11,980,898 |
43% |
10,158,481 |
36% |
(145,973) |
5,885,342 |
21% |
0 |
2016/2017 |
28,261,787 |
11,673,491 |
41% |
10,240,433 |
36% |
(212,989) |
6,030,525 |
21% |
530,327 |
2017/2018 |
30,534,552 |
12,868,853 |
42% |
10,514,353 |
34% |
(130,422) |
5,580,260 |
19% |
1,701,508 |
2018/2019 |
31,590,255 |
13,734,762 |
43% |
10,102,072 |
32% |
(154,730) |
6,347,169 |
20% |
1,560,981 |
2019/2020 |
29,234,158 |
15,589,004 |
53% |
10,524,718 |
36% |
(63,658) |
1,722,856 |
6% |
1,461,238 |
Total |
332,988,481 |
148,535,124 |
45% |
116,789,191 |
35% |
(2,292,612) |
64,702,724 |
19% |
5,254,054 |
Note: Prior year accounts receivables may not reflect accounts that are still being paid on.
The proposed bad debt write-off will be allocated to accounts in past years as depicted in the chart below.
Fiscal Year |
Proposed Bad Debt Write-Off |
2010/2011 |
$69.20 |
2014/2015 |
$964.00 |
2015/2016 |
$3,348.64 |
2016/2017 |
$15,448.75 |
2017/2018 |
$1,238,666.38 |
2018/2019 |
$6,146,902.02 |
2019/2020 |
$1,722,855.87 |
Total |
$9,128,254.86 |
To determine if the percentage of bad debt write-offs is comparable to Florida Counties of similar size and call volume, staff contacted other County EMS departments to obtain their bad debt write-off percentages. At an average of approximately 21% bad debt write-off, Escambia County is consistent with Counties listed in the table below. Discussions with staff from these Counties revealed that the write-off patient profiles were quite similar also, e.g., patients who called EMS but were not transported to a hospital, patients without insurance, and patients with limited income.
County |
Total Charges |
Bad-Debt Write-Off |
Percent |
Leon |
33,403,426 |
6,291,701 |
18.9% |
St Lucie |
21,211,191 |
4,200,000 |
19.8% |
Lake |
26,908,251 |
6,254,625 |
23.3% |
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