Question of the Week — Is it time for a legislative fix to limit sky high air ambulance costs?
As rural hospitals continue to shutter, accessible emergency medical care is out of reach for an increasing number of Americans. When health emergencies arise, patients in rural communities often must rely on helicopter ambulances to get them quickly to care. But the Government Accountability Office reported the median cost for a helicopter ambulance ride was over $36,000 in 2017.
The problem will likely continue to grow. Recent analyses have made dire predictions about rural hospital sustainability. Over 100 rural hospitals around the country have closed since 2010, and as of February 2019, over one-fifth of those remaining were at a high risk of closing.
NPR reports that nearly three-fourths of flights are for patients insured by federal programs such as Medicare, Tricare, and Medicaid. Government payors and private insurers typically pay for a portion of air ambulance bills, but the bulk is billed to the patient.
Currently, states are prohibited from regulating prices for air carriers. While legislators previously considered a fix that would allow states to regulate air ambulances, the measure never made it off the ground. Representatives from the industry lobbied against that effort, and maintain that legislative action is unneeded, instead arguing that Medicare should increase reimbursement and foot the bill, NPR reports.
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Air Ambulances prices should be regulated but also the appropriateness/necessity of EVERY transport should be reviewed by an impartial multidisciplinary team. What will be found is that there is a great deal of “technical imperative” such that if it’s there, use it. Air Vs Ground should be question #1. In rural America, ground is frequently unavailable due to local EMS services having no backup. Every flight is fraught with risk and danger. Airmedical transport has crashes at 13x that of general aviation-those being private aircraft flown mostly by hobby pilots. Airmedical crashes are invariably fatal, with about half involving a patient and worse, patient family. Many services are flying outdated and high risk fixed wing, i.e. 421 Cessna’s and try to fly in weather that would be avoided by recreational pilots. Clamping down on liftoff and loaded miles would reduce the profit motivation of these mostly private, for-profit firms.