North Dakota
North Dakota ambulance providers losing money on every run, according to survey
By: Michael Achterling
FARGO (North Dakota Monitor) – North Dakota ambulance service providers lost nearly $500 on average for every patient transported to a medical facility last year, according to a survey.
The recent survey of three dozen providers in the state, conducted by PWW Advisory Group, was the result of a study created by House Bill 1322 passed during the 2025 legislative session. The group presented the results to the Legislature’s interim Emergency Response Services Committee on Wednesday.
The average revenue generated from an ambulance transport was about $1,100 during 2025, but the expenses were nearly $1,600, said Matt Zavadsky, an EMS and mobile health care consultant with PWW, based in Pennsylvania.
“They are losing money every time they respond to a call,” Zavadsky said during the meeting. “That financial loss has to be made up, typically, by local tax subsidies, fundraisers, bake sales, or all too often, service reductions to try and match expenses with the revenue they can generate.”
He said the problem cannot be fixed by billing reform alone because the revenue generated isn’t enough to fund the cost of readiness, such as personnel, equipment and supplies, among other items.
The survey highlighted 74% of ambulance provider expenses went to personnel costs, but equipment costs have also increased in recent years.
Zavadsky said survey respondents plan to invest about $12.9 million into vehicle and equipment purchases over the next five years, averaging to about $358,000 per provider. However, the cost of a new ambulance has risen to between $275,000 to $480,000 per vehicle. Prior to the COVID-19 pandemic, a new ambulance could cost up to $250,000, he said.
There are more than 100 ambulance service providers in North Dakota. The 36 survey respondents represented a diverse group of providers from city and county services to district-owned, hospital-based and private providers, he said. The average patient transport distance is 34 miles, according to the survey.
Zavadsky said the survey respondents reported 53% of their total revenue was generated from fees for service with the remaining 47% coming from local tax subsidies, state grants and other fundraising.
“What you guys are experiencing in North Dakota and what is happening in the local communities … is not the fault of the local communities, not the fault of the state, this is just our new normal,” Zavadsky said.
Rep. Todd Porter, R-Mandan, owner of Metro-Area Ambulance Service which serves Morton and Burleigh counties, said Medicare patients reimburse ambulance providers at a much lower rate than private insurance and Medicaid patients. He added Medicare patients make up about 60% of the call volume in the Bismarck-Mandan area.
“If we’re being underpaid for 60% of our call volume, then we have to make it up some place,” Porter said.
He said some providers can make up that difference in reimbursement with tax dollars, but not all providers have that option.
“We do other contracted work for nursing homes, hospitals, funeral homes in order to make up that difference,” Porter said. “This is a federal government problem. This is a CMS (Centers for Medicare and Medicaid Services) problem that we’ve known about for years.”
Porter also said ambulance services are not reimbursed for responding to a call with a Medicare patient that doesn’t require a transport to a hospital. According to the survey, about 17% of all ambulance calls don’t require transport to a medical facility.
The survey also showed about 2,300 of the nearly 33,600 patient transports billed last year ended up in collections after being more than 90 days delinquent, totalling $2.7 million, Zavadsky said. The average total of a claim sent to collections was about $1,100.
Zavadsky estimated the total of unpaid claims for more than 100 providers across North Dakota was about $5.8 million in 2025. Some providers don’t have procedures to pursue delinquent billing in collections, he said.
Rep. Jim Grueneich, R-Ellendale, chair of the committee, said the committee will take a deeper look at the data presented on Wednesday and may have recommendations, and possible draft legislation, to address the issue in the 2027 legislative session.
WILLISTON, N.D. (KFYR) – UPDATE (5/10/2026 at 11:45 p.m.): A fire broke out at a Williston recycling business Sunday evening, and no one was injured.
Multiple crews responded to Pallet Green Recycling just before 8:30 p.m., according to the Williston Fire Department. Crews arrived at the scene where they fought heavy smoke and flames.
Industrial storage containers were on scene, and officials say it is unclear what, if any, chemical residue was inside them. Officials believe there is no danger to the public.
Williston Fire Chief Corey Johnson said the fire was contained to the business’s exterior storage yard, and crews were not concerned about it spreading beyond the property.
“Right now, the structures are protected in the area. We’re not concerned about the fire spreading off of the lot,” Johnson said.
Multiple departments from across Williams County responded, and extra water trucks were brought in due to the fire’s remote location.
The cause remains under investigation.
This is a developing story. Your News Leader will provide updates as more information becomes available.
ORIGINAL STORY (5/10/2026 at 9:39 p.m.): Crews responded to a large fire at a storage yard in rural Williston on Sunday night.
The fire is located at Pallet Green Recycling, according to the business owner.
Sylvia Luebke captured video of the scene from a distance around 8 p.m. The fire sent a large plume of smoke over the area. Luebke said it was still burning as of around 9 p.m.
Williston Rural Fire is working to battle the fire. The department was unable to comment at this time.
The cause of the fire is unknown.
Copyright 2026 KFYR. All rights reserved.
Submitted Photo
U.S. soldiers with the Nebraska and North Dakota National Guards, assigned to Joint Task Force-District of Columbia in support of the DC Safe and Beautiful mission, pose for a group photo at a hotel in Alexandria, Virginia, April 28. N.D. National Guard 2nd Lt. Caleb Hill, front row, far left, served as the officer in charge of the mission when soldiers assigned to JTF-DC responded to the shooting incident at the White House Correspondents’ Association dinner April 25. About 2,500 National Guard members are supporting the DC Safe and Beautiful mission, providing critical assistance to the Metropolitan Police Department to help ensure the safety of residents, commuters and visitors throughout the District. U.S. Army National Guard photo by Staff Sgt. Thomas Norris.
WASHINGTON – U.S. soldiers with the North Dakota, Arkansas and Nebraska Army National Guard, assigned to Joint Task Force-District of Columbia in support of the DC Safe and Beautiful mission, responded to a shooting incident at the White House Correspondents’ Association dinner (WHCAD) at the Washington Hilton in Northwest Washington April 25.
The Guardsmen were at the WHCAD at the request of the U.S. Secret Service (USSS) as an additional patrol unit created specifically for the event, which celebrates the contribution of news organizations and independent journalists alike who provide notable coverage relating to the presidential administration.
“Our mission was to assist the U.S. Secret Service with crowd control,” said Capt. Kevin Peatrowsky, an operations officer with the Nebraska National Guard (NENG) assigned to JTF-DC.
As the Guardsmen were monitoring their area of operations, they saw USSS agents sprint toward the hotel entrance.
“They were running full speed with their weapons drawn,” said Sgt. 1st. Class Allen Haney, a team member with the Arkansas National Guard. “We immediately followed suit.”
Staff Sgt. Kirsten Confer, a NENG combat medic and battle captain, recalled her response to the incident: “We fell back on our basic training. You run toward danger and move in a way that makes sense for the situation.”
According to Confer, the Guardsmen entered the hotel and immediately began securing the scene and ensured that the guests evacuated safely. At the direction of a federal agent, Confer began a rapid trauma assessment on the suspect which resulted in finding knives and ammunition on the shooter. Simultaneously, the Arkansas soldiers moved outside to provide crowd control at a pedestrian barricade outside the hotel.
“From there, we assisted wherever we could,” said 2nd Lt. Caleb Hill, a National Guardsman from North Dakota who served as the officer in charge for the mission. “We were initially helping with crowd control. After that, we realized that the USSS had begun rerouting everyone in the hotel, so we moved to the doors. We were controlling entry into the venue, so we had moved a couple more people outside, so we had five inside, eight outside.” Both Arkansas and Nebraska worked well alongside one another and, alongside the federal agencies. Hill also noted that relying on his soldiers allowed him to move to different teams, which helped allow him to plan and coordinate with different agencies.
According to 1st Lt. Jonathan Goins, a platoon leader with the Arkansas National Guard, Arkansas soldiers also helped establish a security perimeter for the staging of the presidential motorcade. Later, the team assisted federal agencies and MPD with crowd control, which helped clear the way for the president and administration officials, he said.
“Guardsmen on this mission represent the very best of the nation,” said U.S. Army Brig. Gen. Leland Blanchard II, the interim commanding general of the District of Columbia National Guard. “The world got a brief glimpse, but I see them each day serving and doing amazing things across the District.”
FARGO, N.D. (KELO) — The Sioux Falls Stampede staved off elimination with a 2-1 overtime win over the Fargo Force in game four of the USHL Western Conference Finals Saturday night.
Thomas Zocco scored the game-winner 12 minutes into the extra period. Arseni Marchenko put Fargo on the board first in the first period. Noah Mannausau tied the game for the Herd in the second period.
Sioux Falls outshot Fargo 53-49, including 9-5 in overtime. Linards Feldbergs made 48 saves.
Three of the four games of the series have gone to overtime. The winner-take-all game five is Tuesday at the Premier Center.
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