As too many of us know, a medical emergency can change your life in an instant. Every day, people experience the pain and suffering of car accidents, heart attacks and strokes. In those moments of crisis, getting to a tertiary care or trauma center as quickly as possible can truly be a matter of life or death.
But for 1 in 4 Americans — that’s 85 million people — getting to a Level 1 or Level 2 trauma center within an hour is possible only if they are flown by an air ambulance. Access to trauma facilities is especially limited in rural communities, where 22 percent of hospitals have closed since 1990. This, combined with our aging population, means the need for air medical services is growing.
As an industry leader in emergency air medical services, the team at Air Methods is dedicated to providing lifesaving health care 24/7/365. Since 1980, we have transported over 2.5 million patients from over 300 bases, serving 48 states. From our safety protocols to our patient advocacy philosophy, we are always working to improve and deliver the best patient experience from beginning to end.
This week, many of our team members are in Fort Worth at the annual Air Medical Transport Conference, a gathering of professionals and experts in the emergency air medical transport industry. As we meet to learn about new technologies and trends, there is one issue that will be front of mind — as we fight to save lives, how will we keep our vital service alive?
While the need for our service is growing, our industry is faced with increasing costs and consistent reductions in payments from insurance companies.
Our best practices medical care is vital to the health outcomes of the people we transport, but around-the-clock readiness comes with significant costs. The average cost to operate an air ambulance base is $3 million annually and 84 percent of those costs are incurred regardless of transports.
About 70 percent of the patients we transport have Medicaid, Medicare, some other government insurance or no insurance at all. The current reimbursement from Medicare, Medicaid and some private insurers are drastically below the costs to provide this vital service. Reimbursement rates for Medicare, for example, have not been updated in almost 20 years, and on average, reimburse only about 50 percent of actual cost of transport. In some states, Medicaid reimburses as low as 1/25th of Medicare.
Air medical services represent about half of 1 percent of the average insurance premium, and yet there are companies that consistently downgrade claims or intentionally keep air medical providers out of network. While many private insurance companies do right by their members and cover air medical transportation at a rate that is fair, some insurance companies shirk their responsibility, leaving patients high and dry. At Air Methods, we want to take patients out of the middle and ensure that, while facing a medical emergency, they can count on their insurance provider to pay a reasonable amount for our service that is requested and deemed necessary by emergency medical professionals.
This reimbursement trend cannot continue without putting our services, and the patients we serve, at risk.
At Air Methods, we’re taking several steps to address these issues. First, we are working directly with insurance companies to make sure they offer fair coverage, and second, we are fighting for smart legislative solutions.
One important proposal comes in legislation introduced in Congress to address Medicare reimbursement: H.R. 3378, the Ensuring Access to Air Ambulance Services Act. This bill would modernize the Medicare air ambulance fee schedule and help preserve these services. The bill requires the industry to collect and submit cost data to the U.S. Department of Health and Human Services so that an accurate payment system, based on actual costs, can be developed. While this only addresses part of the shortfall, this legislation goes a long way in easing the problem. We hope that other members of Congress will join the sponsors of the bill — Reps. Pete Sessions, R-Texas, Jackie Walorski, R-Ind., Suzan DelBene, D-Wash., Bill Johnson, R-Ohio, and Raul Ruiz, D-Calif. — in supporting H.R. 3378.
This week, Fort Worth is filled with people who care deeply about the future of air medical services. But our company and our industry cannot address this alone. We need widespread support for reasonable legislation like H.R. 3378.
Lives depend on it.
Dr. David Stuhlmiller is the chief medical officer for Air Methods.