By Daniel Hankins
Imagine you and your loved ones are hiking through the Chippewa National Forest, fishing on Mille Lacs Lake, or relaxing on your family farm. Suddenly, you start to notice tingling sensations in your arms followed by chest tightness and pain and a struggle to catch your breath. Imagine all of a sudden you're having a heart attack.
When unexpected medical emergencies like this strike, it is critical to access the right kind of care as quickly and as safely as possible. In a state like Minnesota, filled with forests and farms, sometimes the closest trauma center can be hundreds of miles away.
When time is of the essence in emergency situations, air medical services can be the only way to get the life-saving treatment you need.
Today, one in four Americans — about 85 million people — can only get to a Level I or Level II trauma center within an hour if they are flown by helicopter. At the same time, hospitals, especially in rural areas, are closing at alarming rates, with 80 rural hospitals closing their doors since 2010, including two in Minnesota. As a result, access to emergency air medical transport has become more and more critical.
As an emergency physician, I know firsthand that access to emergency air medical services can mean the difference between life and death, especially for the millions of Americans living in rural communities. Air ambulances essentially serve as emergency rooms in the sky, providing life-saving care until they can transport patients to the closest trauma center.
However, access to these critical services is being threatened ("Does the Iron Range need two air ambulance bases?" Aug 18).
Reimbursement rates provided by Medicaid and Medicare, as well as many private insurers, fail to cover a significant portion of the cost to operate air ambulance services. That's alarming when you consider that 70 percent of transport patients are covered by government insurance or have no insurance at all.
Emergency air medical services are standing by ready to respond to the urgent call of physicians or first responders at a moment's notice — 24 hours a day, seven days a week, 365 days a year. Repeated extreme under-reimbursement is making it more difficult for air medical bases to remain open. And, where they remain, costs are unduly shifted to the 30 percent of patients who have private insurance.
All three of the air medical services based in Minnesota are not-for-profit and cooperative in referring patients to other services if their service is not available. All of the services have strong medical oversight to ensure transports are appropriately done.
Thankfully, a bipartisan group of federal legislators recently proposed solutions to address this reimbursement shortfall. U.S. Reps. Jackie Walorski, R-Ind.; Suzan DelBene, D-Wash.; Bill Johnson, R-Ohio; Raul Ruiz, D-Calif.; and Pete Sessions, R-Texas introduced the Ensuring Access to Air Ambulance Services Act. This legislation would require the U.S. Department of Health and Human Services to develop an accurate payment system based on the actual costs of providing care; establish a mandatory quality reporting program; and improve the transparency of costs among providers, patients, and insurers.
Passing this legislation would be an important step in ensuring communities across America — including in rural Minnesota — maintain access to life-saving emergency air medical services.
Whether you or a loved one experience an unexpected heart attack, stroke, or traumatic injury, you may need to rely on emergency air medical services to access immediate care. It is essential we do everything we can to protect and preserve access to these services so they remain a realistic, life-saving option for everyone.
Dr. Daniel Hankins of Oronoco, Minn., is a fellow of the American College of Emergency Physicians and a retired emergency medicine and EMS physician.