According to one research medical flight services run by for-profit organizations had seen, on average, 7 to 8 crashes a year between 1998 and 2012. Of these mishaps, the biggest contributors were those organizations that ran the most medical flights. This raised serious concerns about the safety norms followed by the industry and several studies and investigations were performed simultaneously to make the skies safer for the crew and the patients. The result was some startling revelations. It was seen that the crew was pressured to make as many flights as possible in a day to maintain the profitability of the organizations that they worked for.
What Were the Medical Flight Services Doing?
It was seen that medical flight services were taking orders for new rescue missions even during an ongoing mission. This caused unnecessary operational chaos and instilled a sense of urgency among the crew members. Moreover, it was seen that ground ambulance paramedics were being hired by medical flight services too. This was causing a conflict of interest, wherein the possibility of the paramedics contacting their favored service providers was high. It was also found that some so-called rescues were actually unnecessary as they did not provide any advantage over the ground transportation.
New Safety Laws were Passed
The medical flight industry was subjected to intense scrutiny. Certain safeguards such as maximum permissible hours of work for crew members and laws concerning visibility were put in place. The aging aircrafts had to be replaced by new and safer ones. Upgrades with respect to technology were also made compulsory in certain areas. Better weather reporting and aids for in-flight decision-making were put in place. It can be stated, with confidence, today, that medical flight services are safer and more efficient. The industry and the patients that it serves have benefitted immensely from these developments.
It was a normal family outing for 11-year-old Emilia, fondly referred to as Millie by her family. Never had they dreamt that soon they would be in need of an air ambulance service. The family was out on a horse riding activity when all of a sudden Emilia fell off her pony. That was not all, further aggravating the situation was the fact that the pony’s hoof landed on her jaw. The little girl’s jaw was shattered, and she was in immense pain as the family watched helplessly. That is when the air ambulance service arrived, right in time to offer much-needed help.
The Air Ambulance Service was Crucial
North West Air Ambulance Service was quick to reach the spot and immediately administered morphine to relieve the pain. Once that was accomplished the girl was evacuated to a medical facility where she received jaw correction treatment. The evacuation was done through a land ambulance, but the initial treatment offered by the air ambulance service was crucial. She also got replacement teeth as a few had been lost due to the accident.
The Parents Express their Gratitude
The mother of the child was a first-hand witness to the accident, and she described the incident as horrifying. She was thankful for the air ambulance service that arrived in time for support and treatment. The family, as a mark of gratitude, arranged a charitable event to raise funds for the air ambulance. It was an equestrian event and they managed to raise about 600 British pounds. The family also said that they would do everything in their means to contribute to the medical flight organization. It must be noted in this context that in the United Kingdom, air ambulances depend on charitable contributions by the community to stay afloat. The accident occurred in July, and the girl has now recovered and is healthy.
The life of an air ambulance pilot is risky with weather conditions that transform without warning and the ongoing COVID-19 situation. However, it is not impossible to take precautions and prepare for them. Then, there are mindless pranks that are played by miscreants not fully comprehending the repercussions of their acts. One such act is shooting laser lights at air ambulance pilots. Recently, a Wiltshire air ambulance pilot was subject to one such prank that left him temporarily unable to see and the landing had to be aborted. Just imagine being pilot mid-air, in a situation where visibility is suddenly near-zero. Scary, isn’t it?
The Air Ambulance Pilot’s Family is Scared for His Life
The wife of the air ambulance pilot has appealed to people through a video that was posted on one of her social media channels. The woman breaks into tears as she appeals to people to refrain from shooting laser beams at pilots. The pilot is also a father of twin girls. His wife conveyed through her heart-wrenching video message that she loves her husband very much and hopes to see him walking his daughters down the aisle someday.
She Called to Ban Laser Lights
Laser lights can travel up to 50 miles. This humongous range brings almost all aerial vehicles within its range. It is hard to understand why such a tool must be put in the hands of the public. Laser lights are quite affordable and can be bought for as little as a few dollars. The woman has appealed to the government to pass rules that prohibit the sale of this item.
The pilot in question was on a training mission when the incident occurred. However, had it occurred during a live mission, it would have to be aborted putting the patient’s life at risk owing to delayed treatment.
The air ambulance charities in the United Kingdom are no strangers to celebrity endorsements, Prince William being of the most noticeable among them. However, recently, the industry has found a new patron and that is none other than Gordon Ramsey of the Hell’s Kitchen fame. The celebrity chef has quite a fan following owing to his fiery on-screen critique of various cuisines and cooks. He is also quite popular for his Twitter outreach where he grades food of common people who come to him for validation. His quirky replies are quite a hit in the online community. A celebrity with outreach like this can do loads of good for air ambulance charities.
Cornwall Air Ambulance has Been Gordon’s Choice
It is reported that Gordon Ramsey and his wife have recently spent quite some time in the Cornwall area. During their stay, they have come to realize the important roles that air ambulance charities play to maintain public health. It has this realization that has pushed the couple to help the industry. The organization attends to about 800 incidents, which puts the number to over 2 incidents per day and that is quite commendable.
The Endorsement is Much Needed
Most of the air ambulance charities have been struggling to stay afloat in recent times due to the COVID-19 pandemic. In the United Kingdom, where most air ambulance organizations are charity-based, funding is dependent on community efforts. However, with the highly infectious pandemic gripping the nation, charitable activities have been hard to organize. In this situation, a celebrity like Gordon Ramsey can do a lot of good.
Speaking about his decision, Gordon said, “Cornwall has been our family home now for five years and we have always been totally in awe of the lifesaving work we see the Cornwall Air Ambulance do every day.”
It is believed that the medical flights will be in great demand for most part of the next two decades and will grow at a rate of 9.3%. In the past year, the industry grew to US$ 4,524.7 million. Those are some robust numbers and not the kind we commonly see in the prevailing economy. What are the driving factors behind these trends? It is certainly not the affordability of the people as evident by the growing concerns surrounding the balance bills that never fail to make the headlines. It is the medical need that is driving the air ambulance industry. Here are some sharp insights.
Medical Flights and Diabetes
Perhaps the most common lifestyle disease that prevails today is diabetes. While there is nothing that cries emergency about diabetes, it is a cause for more serious ailments. People with diabetes are known to eventually develop serious heart and kidney conditions, which give rise to life-threatening emergencies. This is where medical flights come into picture. With the US fighting obesity and diabetes (as a consequence), the market is set on an upswing. In fact, currently, there are about 463 million diabetics in the country, and it is projected to reach 700 million in the next 25 years.
Medical Flights and Drug-Related Emergencies
The illicit drug menace has bothered the country for long. Today, it is believed drugs are among the biggest killers when it comes to people under the age of 50. A lot of times, these give rise to serious and unexpected medical emergencies ranging from overdose to motor vehicle accidents. Medical flights are the only recourse in most cases.
Medical Flights and Rural Hospitals
It is a known fact that rural hospitals have been closing down at a rapid rate in the country, and the trend has been up since a decade now. Medical flights are the only way out for the residents of such areas.
In a way, the market for medical flights is a reflection of how healthy the society is.
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.
There has been much anticipation surrounding the new air ambulance bill that aims at curtailing surprise billing practices. However, experts opine that the draft leaves much to be desired for both parties – the payers and the air ambulance service providers. The feeling is that the lawmakers have tried to take a middle ground so as to not displease the air ambulance industry or the medical insurance industry.
From the insurance industry point of view, the fact that it suggests an in-network rate even for those medical flight service providers that are out of network seems like a big win. The provision is something that payers have wanted all along.
From the air ambulance industry point of view, the draft allows for arbitration if there is a dispute with regards to the billing. However, since this comes in the backdrop of a set rate, the industry is not too happy about it.
How is the Air Ambulance and the Wider Healthcare Industry taking it?
The American Hospitals Association has strongly opposed the draft. Their reasoning is that it harms the rural hospitals by limiting the access that patients currently have. The association went as far as saying it is a ‘windfall’ for the insurers ‘at the expense of’ community hospitals. American Association of Medical Colleges too has opposed the draft.
America’s Health Insurance Plans has displayed its dissatisfaction surrounding the provision for arbitration.
More about Arbitration
When it comes to air ambulance companies, arbitration will only be possible for amounts over $25,000. The industry is also expected to provide two years’ worth of data pertaining to costs. This data would be provided to US Transportation Secretary as well as HHS.
The air ambulance industry has been vocal in raising the concerns surrounding patient safety as well as closure of medical bases. They also pointed out that the current insurance payouts by Medicare and Medicaid do not cover even 40% of the costs.
The air ambulance industry has often cited the Airline Deregulation Act whenever questions have been raised against its billing practices. It is obvious that most people are curious about this act that precludes the states from interfering in the matters of the medical flight industry.
The law was originally passed in the year 1978 with the intent of keeping the prices of commercial flights low and to promote a healthy capitalistic competition. Prior to that, the commercial airline industry was seeing a lot of monopolistic moves and the prices were quite high. The Act was quite successful and the primary reason why we see highly competitive prices in the commercial airline market even today.
How did it Affect Air Ambulance Industry?
The credit goes to the air ambulance industry that has successfully argued they too are in the business of commercial flights and, therefore, the states cannot interfere in the matters of their pricing. However, like all industries, there are bad players in the air ambulance industry too. They have leveraged this act to charge incredibly high amounts to the customers. The issue has now catapulted to the extent that it has caught national attention. Some experts believe that strong lobbying of the industry is even influencing federal decision makers.
The Argument against the Air Ambulance Industry
Many believe that air ambulance industry must not be treated as commercial airlines. Instead, medical flights must be treated as public health utilities. Part of the argument is also that the congress – while formulating the act – would not have imagined that the air ambulance industry would interpret it the way it has been at this point. Also, the main intent was to keep the prices competitive and not soaring as is the case today. The air ambulance industry too, on the other hand, has a valid point. It points fingers at the insurance industry, which is known to deny out-of-network coverage.