Air ambulances save lives but reimbursement rates are cutting services

We all know living in a rural state with remote communities comes with a unique set of benefits and challenges, but access to critical, lifesaving emergency care shouldn’t be one. Yet, Kentucky residents are at risk of losing access to air ambulances because the cost of providing care is outpacing the payments received from programs like Medicare and Medicaid as well as private insurance programs.

When Medicare and Medicaid payments are combined with other government programs and the number of uninsured patients is factored into the equation, more than 7 in 10 patient transports receive no or below cost reimbursements. Insurers that once agreed to pay more to cover the low reimbursements from government programs so their beneficiaries would have access to critical services are refusing to continue this practice. Often, this results in patients receiving a surprise bill.

Air medical services are critical to those living in rural areas, serving as mobile intensive care units and transporting patients to the critical care they need quicker than ground services ever could. Americans across the country understand this value because any one of us could experience a serious medical issue like a severe burn, stroke, work accident or car crash that requires immediate and specialized high-level medical care. In these crucial moments, we must rely on air medical services to help.

Each year, thousands of Kentuckians are flown from their local hospitals or accident sites to highly skilled facilities that treat the most seriously ill and gravely injured. People living in rural areas know the importance of air medical services. According to a recent YouGov Survey of American adults, 90 percent consider air ambulances a critical service in healthcare, with 95 percent agreeing that these services help save lives.

The discrepancy between insufficient reimbursement rates and actual costs is made worse by the billing process following an emergency transport for patients with private insurance. Nationally, insurers deny more than 50% of initial claims for air ambulance services in one form or another, which leads to a surprise bill for patients and the start of a long process where providers try to work with insurers over the charges. As providers and insurers work out a resolution, patients with surprise bills are caught in a terrifying and frustrating financial limbo, unsure of their ultimate responsibility.

To address surprise billing, some policymakers propose tying reimbursement rates to “a median in-network rate,” but with many insurers currently refusing to negotiate rates with air ambulance providers, there are often no fair rates to benchmark a median rate against.

However, if legislation currently being discussed in Congress is enacted as written, health insurers will have unprecedented power to determine how much they will pay for air medical services, regardless of the actual cost. This will put significant economic pressure on providers and may cause a cascading effect that will force the closure of air medical bases all across the country, including right here in Kentucky.

Today, 85 million Americans in rural areas rely on air ambulance services to get to a Level I or Level II trauma center within 60 minutes. There are only two Level I trauma centers in the state of Kentucky. Furthermore, there are many in our state who are more than two hours from a trauma center. It is imperative our elected officials recognize the solutions being discussed may have serious, unintended consequences for the families of our state. Surprise billing needs to be addressed, but we need to be sure efforts to solve these problems will not put Kentuckians further from the medical care they need.

Elizabeth Janie Ward is the regional director of base operations for Air Evac Lifeteam.

This story was originally published December 13, 2019 at 9:57 AM.