⚠ PRELIMINARY: NOT FOR PUBLIC USE: These models are unfinished and calculations have not been verified or finalized. They are intended solely for internal discussion purposes. Data and outputs may be inaccurate or incomplete. These models do not represent a policy position, recommendation, or official stance of NCRETAC, its board members, volunteers, or staff.
Model 03: Payer Mix & Revenue by RETAC | NCRETAC Colorado EMS
← All Models Model 03: Payer Mix & Revenue by RETAC Region Revenue Analysis v2.9
EMS Sustainability Task Force — Phase IV  |  Funding Workgroup
APCD-Calibrated Payer Mix & Revenue by RETAC
Colorado-specific revenue by RETAC region. Statewide: $666.8M APCD + $12M HUTF = $678.8M total · $774.3M system cost · $95.5M gap.
Billing Collection Rate
60%
90% 70% Rural / mixed
Statewide APCD billing potential $666.8M × 70% = est. $466.8M net collected · Structural gap at this rate: ~$306.9M (vs $95.5M model baseline)
Source: Morgan County CY2025 (EMS|MC) · GADCS/RAND 2024 · PWW Advisory Group · AMA Journal of Ethics 2025
Coverage key: <15% Critical 15–40% High gap 40–80% Partial >80% Well-covered

Revenue vs. deficit by RETAC

RETAC detail

Commercial rates: CIVHC CO APCD FY25 (A0427, 2023), network-weighted by DOI region. Medicare: CMS Colorado Public Use File ($532.63 urban, $537.85 rural). Medicaid: 80% of Medicare (CO HCPF FFS standard). Payer mix: Urban/Rural/Frontier tiers calibrated from Colorado Ambulance Financial Model and CO demographic data. APCD covers commercial insurance only — Medicare FFS and Medicaid rates are from CMS/HCPF directly. Call volumes: CDPHE ePCR 2023–2024, annualized, distributed by vehicle share within RETAC. Source: GAL registry May 2025.