The air ambulance industry has been in the headlines for quite some time now. Most recently, however, it was because the state of Wyoming was attempting to regulate it. The hurdle was (and is) a federal regulation that prohibits state governments from interfering in the affairs of air ambulance industry. However, the attempts were rejected by CMS. Wyoming had proposed that the states must be allowed a say in the matters of air ambulance industry. It had done so to keep the cost of medical flight services at bay as they have been getting steeply expensive recently.
Does this Mean the Air Ambulance Industry has Won?
The answer is “yes.” At least for now, the air ambulance industry seems to have won. The CMS verdict favors the medical flight service providers. They will not be subjected to any state control and will be free to fly across state borders and also charge the consumers what they feel is the right amount.
The industry had feared that if they are forced to come under insurance networks, they will then have to conform to the reimbursement rates that are set by the insurance organizations. This was especially worrying since the rates have not been revised in over a decade. Moreover, since bidding system to offer services for a particular state would have come into picture, there were high chances that some insurance companies would have gone out of business.
What does it Mean for Consumers?
Consumers will now have access to a wide range of air ambulance companies. This means they will be able to avail specialized medical flights during emergencies. Since the profitability will remain unchanged, the air ambulance industry would find it financially encouraging extending their reach to remotest parts of the country. There, however, is one drawback. Since insurance companies have not still revised their reimbursement rates, the consumers are at risk of high out-of-pocket expenses.
A recent survey has shown that medical flight services are now more open to insurance network participation. In fact, the numbers have gone up by a healthy 20%. It has also been seen that the medical flight services and insurance companies are holding intense discussions and negotiations surrounding in-network arrangements.
The reason behind this change has been the huge increase in consumer demand and also to steer clear of the negative publicity that both the industries have been subject to in recent times. The efforts by the state governments to regulate air ambulance pricing and also getting insurance companies onboard with their cost-controlling measures have seen a lot of backlash recently.
The Medical Flight Services and their Cost Compulsions
The refusal of the insurance companies to take cognizance of the fact that maintaining medical flight services is an expensive affair – some say – was the cause of all the misunderstanding. Air ambulance companies usually spend a fortune to remain on standby for emergencies. The cost, of course, is then transferred to their services. When insurance companies refuse to foot these costs, the burden unfortunately is transferred to the patients who avail the service. This is a practice that is popular as ‘balance billing’.
How In-Network Coverage Helps
Customers are able to enjoy discounted and ‘fair’ out-of-pocket expenses to cover medical flight services when in-network coverage becomes a reality. In an ideal world, all air ambulance services providers must be in-network. However, the onus of it does not lie only on these emergency service providers. The insurance organizations too must be willing to reimburse a fair amount. Otherwise, it simply does not make business sense for medical flight services to join any network.
The good news, however, seems to be that both these industries are coming around and finding common grounds to work together.
When it comes to communities funding air ambulance services, United Kingdom leads the way, and there is no doubt about it. It is the involvement of the locals that makes it happen. People are known to undertake several community efforts, no matter how small, to keep the medical flights funded. From marathons to selling cookies, people contribute in their own way through innovative fund-raising efforts. The question that such undertakings raise is this: does this method work across the board? The answer to this simple question, however, is quite complex and the success is dependent on several factors. Let’s take a look at some of them.
The Absence of Significant Private Air Ambulance Companies
In a country like the United States, there are several private players who do an exemplary job to provide air ambulance coverage. They span a wide network of rural areas with zero compromise on quality of transport. The problem, however, is the price that they charge. In the absence of adequate insurance coverage, they can turn out to be a huge challenge to pay off. Of course, there is the issue of network coverage and surprise billing that has got the country concerned lately. This is the prime factor that is pushing people to look at alternate means of funding air ambulance services.
Community Funding is Not Always Successful
The estimated cost of keeping air ambulance services floating runs over a million dollars. Even the most successful charitable medical flight services do not rely solely on community funding to satisfy this need. Governments and corporate organizations play an active role in their funding. Moreover, prominent personalities are known to raise awareness and extend support to raise awareness about the services. In the United States, however, such an ecosystem is completely missing. Unless there is a concerted effort to get it in, such efforts are bound to fail.