This story by Patrick Bilow was first published in the Stowe Reporter on Dec. 4, 2025.
Stowe Emergency Medical Services is raising its rates to keep up with the ever-increasing cost of aiding people in the area.
According to Assistant EMS Chief Scott Brinkman, the gap between billed revenue and the cost of providing services has widened over the years. Operational costs, including medical supplies, equipment maintenance, fuel and recently implemented personnel wages are outpacing revenue, he added.
The department is also missing out on some reimbursements for service, either through inconsistencies with billing out-of-state patients or non-payment after service, the cost of which the town of Stowe absorbs as bad debt rather than sending patients to collections.
“We haven’t sent an ambulance bill to collections since we started billing in the late 80s,” Brinkman said. At the time, the sentiment behind that decision was to not bill Stowe residents who either don’t have insurance or can’t afford a service, and who already support Stowe EMS through taxes, Brinkman said.
In addition to billing, the department relies on taxes and a nonprofit for revenue.
To narrow that gap between operational expenses and revenue, Stowe EMS is raising its rates by more than 100% in some cases. The bill for a critical care transport, the department’s most-costly service, will more than double from $1,250 to $3,210.
ALS 1 and 2 Emergency responses will increase from $1,000 to $1,8000 and $1,400 to $2,716, respectively, and BLS Emergency services from $750 to $1,500. Higher rates will allow the department to recoup costs from a convoluted healthcare system with different policies and reimbursement rates.
Prior to the rate change, Stowe EMS offered a basic level of service that cost $1,000, but depending on a patient’s insurance policy, the reimbursement for that service ranged from full to partial. As rates increased and became more nuanced in surrounding towns, Stowe EMS realized it was leaving money on the table for policies that reimburse in full.
“So, by raising our rates overall, there are going to be times where we make the entire rate,” Brinkman said, “and that’s going to help us with all of the write offs we have to do, or the contractual allowances we have to accept for billing Medicare and Medicaid.”
Brinkman likened the rate change to a familiar convenience store exchange.
“If you went to Maplefields in town for a coffee, and you were on some kind of a program that the state covered that cup of coffee for you, and Maplefields was only making 40 cents on that cup of coffee, then they might raise the rates for a person walking in the door that doesn’t have that assistance, so they can make up the difference,” Brinkman said.
As rates increase the department is also trying to recoup reimbursements from out-of-state patients, which Brinkman said accounts for roughly half of EMS calls nowadays, a trend that has shifted over the years.
According to Brinkman, the department noticed that reimbursement checks are sent to homes for out-of-state patients, rather than the department for in-state patients. Oftentimes those checks don’t make it to Stowe.
“We aren’t trying to put ourselves in a place that is, three times the price of an ambulance run in another neighboring town or anything like that,” Brinkman said. “We’re just trying to stay competitive.”
Correction: A previous version of this story incorrectly described the “critical care transport” service offered by Stowe EMS.
