Providing reliable ambulance coverage in the Lisbon and Mt. Vernon communities is becoming increasingly difficult due to inadequate insurance reimbursement models. Like many rural EMS providers, the Lisbon-Mt. Vernon Ambulance Service relies heavily on payments from Medicare, Medicaid, and private insurance. Unfortunately, these reimbursements rarely cover the full cost of delivering emergency medical care, especially in a rural setting where call volumes are lower but readiness costs remain high.

In many cases, our service is only reimbursed if a patient is transported to a hospital, meaning essential services such as on-scene evaluations, lift assists, and non-transport medical care go uncompensated. Additionally, Medicare and Medicaid rates often fall well below the actual costs of staffing, training, equipment, fuel, and maintaining 24/7 availability. Historically the cost per transport was only a difference of $150.00 - $200 above the average reimbursement. As costs increase and reimbursement rates stay stagnat this gap has increased and has become more difficult to offset with grants and fundraising. The demand for services increasing also means LMVAS needs to expand to provide more consistent service to the community by moving to a hybrid staffing model with both career staff and volunteers. 

This is why local tax funding is not just helpful, it’s essential. 

Unlike law enforcement and fire protection, there is no obligation for a community to provide an ambulance service, and that means there historically has not been a way to fund EMS. More recently, the State of Iowa has approved and modified legislation to allow for Emergency Medical Services to be considered essential and have a mechanism for tax funding. Tax revenue provides a stable, dependable source of funding that would allow LMVAS to maintain round-the-clock service, hire and retain skilled paramedics, invest in modern ambulances and life-saving equipment, and ensure rapid response times for every emergency—whether the call results in transport or not. This essential funding will cost an owner of a $300,000.00 home approximately $7.50 per month to have a staffed paramedic 24/7/365.

Without tax support, the Lisbon-Mt. Vernon Ambulance Service would face difficult decisions that could include reducing coverage, delaying response times, or scaling back operations—compromising the safety of our residents.

Supporting EMS through local taxes ensures that when you or your loved ones call for help, professional care will be there—day or night, no matter what.

Percentage of Payors and Average Reimbursement

LMVAS Cost per Transport, 2024: $926.71*

National Average for the Midwest: $2,673.00

Medicare Average Reimbursement: $681.59

58% of Transports

Medicaid Average Reimbursement: $176.60

11% of Transports

Once Medicare and Medicaid are billed, LMVAS does not receive anymore than what they approve to reimburse for services. 

*This number does not reflect the average amount billed, but the cost to perform the transport with all costs included.