Well this might not come to you as a surprise because you might have witnessed this yourself. According to one survey conducted by Kaiser Family Foundation, about 40% of US citizens have revealed that their families have received a medical bill despite being covered by medical insurance. This is a growing problem for the country as insurance companies are seen restricting the number of providers in their networks. Of course, out of network providers are not covered by insurance companies. In this context, the question arises, is it the same logic behind huge medical flight bills that people across the country are witnessing?
Medical Flight Bills and Insurance Network
A majority of industry experts believe medical flight service providers willingly stay out of insurance networks. The reason is simple, they lose the freedom to charge what they feel is fair for their services. It is also felt that there is a huge disparity between what the medical flight industry believes is a fair payout and what the insurance industry pays. The middle ground, it seems, is something that has not been achieved so far. The issue has not gone unnoticed by the lawmakers. However, the opinion is divided as to who is responsible for the huge bills.
Efforts by Lawmakers to Bring Down the Bills
Several attempts have been made to limit the amount that can be charged for medical flight services. From trying to ban balance billing to compelling air ambulance companies to come under insurance networks, several innovative efforts have failed. The reason behind this is the Airline Deregulation Act of 1978. Designed to create a competitive environment to keep the price of this essential service down, it precludes the state governments from intervening in the matters of air ambulances. Only the Federal Government is authorized to make changes.
Air ambulance services play a critical part in providing medical care on time for stroke victims. The Centers for Disease Control estimates that about 795 thousand people suffer strokes every year in the United States of America. Up to 140 thousand of these people die of stroke. Approximately 610 thousand people have never experienced stroke before. To put these numbers into perspective, one person has a stroke every 40 seconds on average in the country. All these people need air ambulance services to receive care on time. If not, they are at risk of suffering disability for the rest of their life.
Air Ambulance Services are Time Critical in Stroke
It is said that the chances of survival and complete recovery improve drastically if the patient receives care within the first three hours of the stroke. Air ambulance services play a major role in ensuring that this. The fact that rural doctors are moving towards urban areas and the reality that rural hospitals are closing at a rapid rate makes air ambulance services for such regions critical and life-saving. These patients are in need of high-level care facilities equipped to handle this medical condition.
The Economics of Stroke
In the US, cost of stroke treatment is approximately USD 34 billion annually. This includes the cost of care, medicines and loss of work revenue due to medical absence. Despite this, insurances only cover about 30 to 40% of the cost related to air ambulance services. Why? Because the reimbursement rates have not been revised for over 20 years, which puts a lot of financial strain on air ambulance services. The result – medical flight service providers are closing at a rapid rate, especially in rural America. If something is not done about this by the congress, it could turn out to be a grave situation for the people in the near future.
The medical flight industry is highly competitive with hundreds of organizations offering this emergency service around the world. With insurance companies not always covering the full cost of the medical flights and people being wary of the high price involved, the question that is being contemplated is whether lowering the standards of service within the legal realm a viable option. Among the cost factors are maintenance, fuel, hangars, and staff. While the first three are almost impossible to control, staffing is something that most are looking at. Here are a few things that some medical flight providers around the world are considering according to a recent survey by ITIJ.
Cutting Down Medical Flight Staffing and Training Costs
Of course, the more experienced professionals such as doctors, nurses, paramedics and pilots come at a huge cost. But then, there are low-cost medical flight service providers who lower their standards when it comes to hiring standards. It must be noted in this regard that staffing is among the highest recurring expense for most companies.
Training can be expensive too. In order to maintain accreditations, constant training programs need to be held and medical flight companies must make way for the accreditation agencies to evaluate them. All these activities can push the costs high. Doing away with accreditations can cut the cost to some extent and this is among the reasons why several medical flight service providers veer away from them.
Containing the Cost of Equipment
The medical flight industry is constantly evolving, especially when it comes to technology. Using outdated equipment that is still legally acceptable is a choice that many air ambulance companies are contemplating today.
The question that one must ask in this context is whether this is the right path to take. People are entitled to best care possible at reasonable costs. How this can be achieved is a question that only future will tell.
Imagine heading a business where customers only pay you 30% of the time in full and the remaining 70% only pay you 50% of the cost. How would your business survive? This is precisely the situation of most air ambulance companies in the United States of America say industry experts. What adds insult to the injury is the fact that there is a outcry about the charges both in national media as well as people, not to mention the politicians who are trying to pin all the blame on air ambulance companies. Most players in the industry say that air ambulance business is getting harder by the day to run.
Air Ambulance Companies Asked to Do More
Rural hospitals in the US are closing down at a rapid rate. More and more rural patients are veering towards the services extended by air ambulance companies. However, the fact remains that air ambulance services are expensive and the costs are not being reimbursed by health insurance providers citing several reasons. While the most common is the ‘lack of medical necessity’ others simply have a small ceiling of reimbursements that have not been revised for a very long time.
Most of the Air Ambulance Costs are Fixed
Costs of running a medical base is, on an average, about USD 3 million a year. This amount accounts for about 85% of the costs and are fixed. These include maintenance of the aircraft, hangar, support staff, crew and the like. Then there are write-downs that are either forced upon the air ambulance companies or the ones that they undertake themselves on humanitarian grounds. All this adds up to a huge amount. Plus, there are always the running costs such as fuel which is also quite expensive. Industry experts feel that the demand for the services provided by air ambulance companies is going to increase considering that the population is aging, and that something needs to be done on a war footing to make the reimbursements commiserate with the services provided.
We have been citing the reluctance of insurance companies to revise their payment charts, in keeping with the time and also several air ambulance companies that simply refuse to budge down when it comes to the pricing.
This time around, Missouri Insurance Department has come up with a report that reveals, on an average, people of Missouri are paying about USD 20,000 for an air ambulance services. Of course, this is a whopping price for a common person, not just in the state but anywhere in the world. The report further said that close to USD 26 million was billed by air ambulance companies in the year 2017. Of this, 12.4 million is what people had to bear, taking into consideration deductibles and co-pays.
Does the Report Vilify Air Ambulance Companies?
This was a question that air ambulance industry advocates would raise without a doubt and not for any frivolous reasons. Balance Billing, which forces patients to pay the amount when insurance companies refuse to clear the air ambulance bills, had no mention in the report. The reason stated for this was ‘insufficient data’. One could even say that the lack of this data, sort of makes the report a little lopsided.
High Fixed Cost was Cited by Air Ambulance Companies
One aspect that should be appreciated about the air ambulance companies is that they have not shied away from saying the amounts charged to the patients are pretty steep. They have also expressed their helplessness in containing this, as the fixed costs of maintaining a medical flight is very high. However, what goes against the favor of some air ambulance companies is the fact that they are unwilling to come in the network of insurance providers.
As we have always stated, the air ambulance industry and the insurance industry need to come together to find a middle path, so that the common person does not have to bear the burden of huge bills.
When faced with an emergency situation concerning the life of a loved one, cost is the last thing that you want to worry about. However, it is always wise to have an idea of the costs involved in emergency situations and medical flight services are one of those. With the cost having doubled over the past decade, you must know what to expect if you’re opting for a medical flight. While most of the costs will be covered by your health insurance, you would still want to keep the costs low as you might be forced to pay the unapproved balance amount as it so often is seen happening.
The Cost of Ground Transportation
One cannot completely discount the fact that a ground ambulance may be required to transport the patient. It becomes an absolute necessity when it’s a fixed-wing medical flight, which can only take off from an airport. Even choppers can, at times, not reach the patients owing to the terrain and ground ambulance services may be needed.
The Destination of the Medical Flight
This is an obvious factor. The longer the medical flight, greater the cost. The nearest appropriate treating facility might be quite far and sometimes across borders – all this ultimately translates into higher cost.
Medical Flight Landing Fees
The landing fees depend on the duration that a medical flight uses the landing facility. This becomes a part of the final bill.
Type of Medical Flight and Number of Medical Staff
Long flights typically demand fixed-wing air ambulances. These can be more expensive than choppers. They are generally better equipped and considered more comfortable. The number of medical staff is also a criterion. Certain medical conditions demand that professionals in more than one field of medicine be present in the air ambulance and this can push the costs up.
While there may be other cost factors too, the ones discussed above are the major ones.
The last thing that comes to mind during emergencies is money. Staying alive takes priority over everything else and naturally so. It is after the emergency and when you are inadequately covered by insurance that air ambulance cost finally comes into picture. There are several factors on which medical flight costs depend on. In this guide, we briefly discuss the important cost factors.
The Distance that Air Ambulance Needs to Cover
Unlike a cab that usually considers the distance from the point that you occupy it, air ambulance charges go beyond this point. You might be expected to cover the cost from the air ambulance base to your location and also for the journey undertaken by the air ambulance to get back to its base. Opting for the nearest air ambulance might make more sense in situations like these.
The Type of Air Ambulance Vehicle
For longer distances, an air ambulance with a jet engine might be more suited. Of course, this might translate into higher costs. At the same time, helicopters are ideal for emergencies that occur on busy streets. While one cannot exactly choose which vehicle to hire, it must be understood that aircraft type and costs are directly related to each other.
The Extent of Care the Health Condition Demands
There are two components to medical care: personnel and equipment. If the condition demands that the air ambulance be loaded with advanced life support and monitoring systems, the costs will shoot up. Also, there might be a requirement for specialized human care that only highly skilled professionals can provide. And such care usually comes at a premium.
Air Ambulance Landing Fees and Logistical Charges
When an air ambulance lands on an airport or helipad, it is usually charged a fee for it. Also there might be other charges such as visa, hospital booking, ground ambulance charges, etc. Your air ambulance service provider is obviously going to factor all that in while drawing the bill.
Imagine being in a situation where your loved one has a serious health condition that necessitates use of an air ambulance service and you are left worrying about the cost of utilizing it. No one would want to be in a situation like this. But what if the air ambulance service that you choose offers to help you with the insurance? Yes, there are air ambulance companies out there that will aid you in getting adequate insurance reimbursements. They even hire qualified personnel for this specific purpose. These experts can even give you an idea whether your claim is likely to be accepted or rejected.
Medical Necessity for Air Ambulance Service
There is no denying that the medical necessity for using air ambulance service needs to be established first. How do you achieve that? Well, frankly speaking, it is not in your hands. The physician treating the patient will determine whether the patient needs air ambulance service or not.
If the treating physician deems the use of air ambulance service a medical necessity, will that mean you will get insurance cover? Well, not always. There is the medical director of the insurance company that comes into picture. It is in the right of the medical director to dispute the claims of medical necessity by the treating doctor. If he or she does so, the insurance cover may be denied. However, if you are in good hands, the air ambulance service may try to pursue the insurance reimbursement until the end.
What if the Efforts of the Air Ambulance Company Fail?
That’s a very unfortunate circumstance but not unheard of. If your insurance provider refuses payment and you do not have an air ambulance membership, you might be asked to pay the amount out of pocket. However, most air ambulance service providers offer discounts in such circumstances. You need to be ready to negotiate hard so that you end up paying the minimum.
If your loved one is in need of air ambulance transport and if you have enough time in your hands to choose among the various service providers, would you still opt for a broker to choose one? If your answer is yes, think again. Here, we list a few reasons as to why you are better off scouting for an air ambulance transport yourself.
Cost of Air Ambulance Transport
An air ambulance transport broker usually pours in all efforts to give you the cheapest available option out there. Of course, this is good but one needs to keep in mind that the cheapest is not always the best. It is necessary to look into other aspects too. Moreover, the broker will invariably add his charges to the overall cost of air ambulance transport. If you look for an air ambulance yourself, you can save this money.
Ability to Answer Questions About Air Ambulance Transport Service
Keep in mind that the broker is not a representative of the air ambulance transport company. He would therefore have limited knowledge to allay all your fears and concerns. This can be a major disadvantage if you are anxious about the whole thing. When you choose to find an air ambulance transport company yourself, you would be dealing with the representative of the company who would be in a better position to clarify all your doubts.
Do the Legwork for Air Ambulance Transport Yourself
Spending a bit of time to find an air ambulance transport service yourself can free you of a lot of worries. Most of the time, all it takes is looking online for a few phone numbers of air ambulance companies and calling them up. The air ambulance transport coordinators would do the rest of the work. Spending a couple of hours to perform this task can save you money and worry.
RVSM is an abbreviation that stands for Reduced Vertical Separation Minimum. RVSM-approved medical flights must be fitted with certain gadgets such as autopilot and certified altimeter. These medical flights are allowed to fly 29,000 feet above the sea level.
RVSM allows aircrafts to fly maintaining reduced vertical distance between each other; thus, paving way for more medical flights to share airspace simultaneously and safely. While this may seem quite technical for a layman, there are other distinct advantages of flying above 29,000 feet. It brings speed, comfort and safety. Let’s discuss the importance of RVSM, especially with long-distance medical flights.
Safety of Medical Flights and RVSM
Safety is always the primary concern when you choose an air ambulance. Medical flights coursing at lower altitudes are more susceptible to turbulence. Such turbulences can cause unnecessary anxiety in the patient which is not advisable when the condition of the patient is critical or the patient is already anxious about his or her health.
Speed of Medical Flights and RVSM
Time is always of essence when choosing an air ambulance. Medical flights flying at higher altitudes fly quicker and burn lesser fuel. This means that the air ambulance does not have to stop frequently for fueling. Circling the airport, landing, fueling and resuming flight can be quite time consuming and RVSM approved medical flights avoid/ reduce such hassles greatly.
Comfort of Medical Flights and RVSM
The reduced chances of turbulence, when flying at higher altitudes, make travel comfortable for the patient. The difference in comfort level is not too great but for a patient who has a fragile health condition, the small difference can mean a lot. There is also the peace of mind that comes along when you know that the aircraft carrying you will take lesser time.
Cost is always a consideration when choosing medical flights. The fact that a RVSM approved aircraft burns less fuel could translate into lesser costs for you.