Among the most important factors that count when it comes to medical flight risk assessment according to the Federal Aviation Safety Administration is having an accurate flight risk assessment tool. Such a tool enables the pilots to evaluate the flight risk well in advance and to make an informed decision whether to proceed with the medical flight rescue mission or not. An efficient tool enables the pilot and the flight team to develop a risk mitigation strategy that is effective enough. It includes everything from weather condition assessment to cabin preparation for the patient who will be onboarded. However, there are several other factors, too and often, it is an evolving situation that the risk assessment tool must factor in.
The Changing Medical Flight Risk Landscape
Pandemics, volatile political conditions, conflicts, sudden weather changes – the factors that result in increased medical flight risk are several. The tool must take into consideration all these factors. Of course, the tool must work on inputs received digitally as well as through manual human intervention. There are specialized disciplines when it comes to such assessments today. Not to forget the numerous safety organizations throughout the world. However, sometimes the safety standards of one country can conflict with another.
Medical Flights Across Borders
Crossing certain international borders is considered low risk. For instance, a medical flight company would not think twice before flying a patient between the United States and the United Kingdom. However, the considerations vary vastly when, for instance, when it is between a country like Sudan and the United States. Of course, not all medical flight companies undertake missions in countries that are considered volatile. Having said that there are private medical flight companies today that specialize in undertaking missions from high-conflict nations. It all boils down to the adequacy and the efficiency of the risk models, tools and human expertise that they employ.
Every year, over 400,000 medical flight evacuations and rescues take place in the United States and each ride can cost up to $25,000. Going by these figures, it is obvious that the market potential is huge. This is a fact that has not gone unnoticed by private equity investors. It is, therefore, no surprise that the country has over 75 medical flight companies that have about 1,500 air ambulances. A big number no doubt but it also means that the market is competed out by these numbers. Now, add the burden of increasing security standards and the profit margins begin thinning significantly.
Medical Safety Standards Constantly Evolve
When you look at the number of medical flight accidents that take place, it is certainly much smaller than the road accidents that we witness every day. That’s because the safety standards of the industry are quite high. The reason behind this is the constantly evolving safety benchmarks laid down by institutions like the Federal Aviation Administration of the country. These agencies make it impossible for medical flight companies to adopt a lax attitude towards safety. They simply cannot fly without following the specified safety standards and defying them or trying to break the rules can result in license suspension, financial penalties and more.
Regulations are an Incentive for Safety
Regulations not only govern safety surrounding the customers, but they also cover the crew members. For instance, any medical flight taking to the skies in the evenings or in a bad light must equip its pilots with night vision technology. Coming to the cost of safety, this is one area where the medical flight industry is left in the lurch. The increasing costs are not given due consideration by the insurance companies forcing the medical flight companies to put the burden of payment on the end consumers.
Infections even after COVID-19 vaccinations are rare but not unheard of. Moreover, the world is today witness to newer variants of the virus and no one knows for sure where the mutations are headed. In this scenario, owing the right medical insurance is of utmost importance. It is every individual’s responsibility to understand what is covered under the insurance and what is not, especially when it comes to medical flight services. Finding out that you have inadequate coverage at the very last moment when you need a medical flight can be disastrous, especially since the cost can veer you towards bankruptcy.
Coverage for Medical Flight Services
Adequate medical flight insurance coverage is especially important for those who travel overseas. Of course, it goes without saying that a comprehensive travel insurance is important. However, not many people understand the importance of looking into the fine print about whether medical flight evacuations are covered or not. If covered, what is the kind of coverage that you would be getting. One must keep in mind that international medical flight evacuations can be extremely expensive and can run into several thousand dollars, often running into eight-digit bills.
What Coverage do you Need?
Some travel insurances will only offer to admit you to the nearest adequate medical facility. That means that you might end up with the best possible treatment but in a developing country or an underdeveloped country. On the other hand, if your insurance promises that you will get treatment closer to your home in your nation, it may necessitate a medical flight evacuation. What you want is a health insurance policy like that. The premium may be slightly higher, but you can breathe a sigh of relief and travel confidently to any corner of the globe. This is especially important in the context that much of the world remains without access to COVID-19 vaccination.
Medical flight personnel is often involved in highly tense situations where quick decision-making and execution can mean the difference between life and death. What does this mean? We are alluding to the need to engage the mind and both simultaneously without being deterred by tough situations. The training module of medical flight professionals must take this factor into consideration. Gamification of their training can achieve this effect. Of course, there is no comparison to real-life experience that these trained individuals will later get. However, gamification ensures that even rookies display better responses within a shorter period.
Designing the Right Training for Medical Flight Professionals is vital
Designing the curriculum and transforming it by introducing gamification is no small feat. Obviously, it is not something that a regular game designer or an academician can achieve. The effort demands that highly experienced professionals with real-time medical flight experience are involved. It is a giant step away from the regular classroom lecture. That said, it must be noted that how much ever mundane classroom lectures may seem, they cannot be done away with. Human interaction is always going to trump any other form of knowledge transfer.
How will Gamification Improve Learning?
Gamification, of course, uses technology as its crutch. However, it also enables this model of training to be personalized. One cannot expect a human trainer to devise a training program that is specific to each individual, but when you employ technology, this becomes easy. Machine learning algorithms can quickly understand each person’s speed of learning and adapt accordingly. Moreover, it is free of human emotions so things like frustration are never in the picture. You can ask a computer program to explain something of a medical flight to you any number of times with zero hesitation. Of course, the medical flight industry must first buy into this concept if it is to become a reality.
The qualifying standards for being a medical flight pilot are quite high and require thousands of hours of flying experience. Besides, there are license requirements, night flying experience, and so on. The list is quite extensive. Most medical flight companies have their own hiring standards. If you are wondering why that is so, here is the answer. Medical flight pilots often have to work in extreme conditions and experience can come in handy in such situations. For instance, landing a helicopter in the middle of a busy highway, navigating between power lines and other obstructions can be quite nerve-racking. Only experience can come to the rescue in such scenarios.
Single-Pilot Medical Flight
The most common of the configurations among medical flight aircraft are single-pilot. The crew usually consists of a nurse and a paramedic along with the pilot. This necessitates that the pilot is a good team player. Often, he or she may need inputs from the crew members when it comes to visibility, especially during low light to avoid cables and other obstructions. The medical flight pilot must be able to verbalize the need for input clearly keeping in mind that advice is being sought from unqualified and non-technical personnel.
Working in Shifts
Medical flight services are usually open for service all hours of the day throughout the year. This means that the pilot will have to work in shifts. Besides, some medical flight service providers expect the pilots to work in staggered shifts where the first few hours could be in the morning and the rest, later in the day. There are also instances where medical flight pilots are expected to work seven days straight, 12 hours each and then take off the entire next week.
It goes without saying that the work-life of a medical flight pilot is quite exciting but it does come with a lot of responsibilities.
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.
Medical flight membership programs have always been around, although not many have been very popular. Now, with the regulations surrounding surprise medical bills, medical flight service providers are thinking of new ways to stay afloat. Will this mean that membership programs will be redesigned by most of them? It is a question that has remained unanswered, but something that the industry must look at closely.
The disconnect between medical flight service providers has been that they do not honor each other’s memberships. This leaves the members with limited options, wherein they are confined to availing services only from a few medical flight services. In emergencies, they may end up hiring any air ambulance service.
Will the Medical Flight Service Providers Come Together?
This is a big question that has remained unanswered so far. However, the medical flight industry has much to gain if this becomes a reality. Imagine how convenient it would be if one membership would cover all the medical flight services across the country and even across borders. Members simply would not have to worry about the cost. All they would need to do is pay an annual membership fee and the whole family would be covered.
Will Memberships Continue to Remain Popular?
It is likely that medical flight membership programs will gain in popularity. This will be the case even if there is an end to surprise billing. The reason is this: non-emergency medical flight services may still demand out-of-pocket payments. Having a membership can negate this issue. It is for this reason that medical flight memberships will continue to retain their utility. Plus, with the pandemic still not under control, air ambulances can come in handy, especially if it involves flying huge distances for appropriate treatment. The one factor that will continue to retain focus is the acceptability of memberships across service providers.
The COVID-19 situation has caused a lot of problems throughout the country. The treatment expenses sometimes are very huge and the need for treatment highly urgent. A family from Central Florida was in one such situation. A family member had contracted the COVID-19 infection and was on a ventilator. The hospital that he was being treated had conveyed to the family that the patient needed to be transported to a more appropriate facility. The family had then contacted a medical flight company to transport the patient. The cost of the flight was going to be over USD 16,000 and the medical flight company had helped the family set up a GoFundMe page.
The Medical Flight Service was Not Availed by the Family
There are two versions that are currently going around. The family, on its part, revealed that they had canceled the medical flight due to certain apprehensions and the constant demand from the medical flight company for funds. They had arranged for another air ambulance service and had conveyed it to the first company. However, they later found that about USD 8,000 was withdrawn from the fund by the medical flight company.
The Version of the Medical Flight Company
The medical flight company said that the family was insisting that the patient be transported despite the treating physician not giving permission to do so. For this reason, the flight had to be rescheduled. Further, this had gone on for quite a few days. They revealed that, ultimately, they had got a text message that they no longer needed the medical flight service and the patient’s family had stopped responding to their attempts at communication. In fact, the air ambulance company had already arrived, ready to transport the patient when the cancellation was conveyed through the text message. Due to this, the air ambulance company had charged the family USD 8,000.
Although the congressional bill that seeks to ban surprise billing is not limited to the medical flight industry, much has been made out about it. The bill will span the entire medical industry including doctors and medical service providers. Since the bill is Federal, it will apply to the medical flight industry too. However, this long-drawn bill was seen as a battleground with insurance providers on one side and the rest of the medical fraternity on the other. Who won the battle? This was the question that most people were asking at the end of it all.
It was a Balanced Bill with No Defeats
The main source of contention was the fixing of prices for various medical services. The insurance industry was bent on fixing it according to their prevailing rates, which, frankly, were outdated. On the other hand, the medical fraternity, including the air ambulance industry, wanted the government to consider its price list. However, it was widely believed that the list consisted of highly inflated prices. Realistically, it was never expected to be accepted even by those who were advocating it. The congressional bill has skilfully navigated between the industries to ensure that all involved parties get a fair deal.
Medical Flight Services Get the Option for Arbitration
The dispute about medical flight bills has always been between the insurance and the air ambulance industry. However, common citizens have borne the brunt of it. Now, however, the bill will introduce a mechanism for arbitration between the two parties so that they can sort it between themselves and leave the patients out of it. This will ensure that no patient gets a surprise medical flight bill even if the provider is out of network. The bill goes on to suggest protection for those without insurance too, in case of health emergencies. The way forward, it seems, is coming to a consensus for both industries.
A bill concerning the surprise billing practices of the medical flight industry might bring a solution soon. The insurance companies and the medical flight industry have been in the midst of a heavily fought battle around this. Both parties have time and again blamed each other for the high air ambulance bills that patients receive. Such developments have also resulted in bad press for both the players. However, bringing the air ambulance industry to compromise on its billing practices has so far seemed impossible. This is mainly because the states have little control over them and the Federal Government has been sitting over it for quite some time.
The COVID-19 Situation and the Medical Flight Bill
The COVID-19 pandemic had definitely delayed the passage of any bill related to surprise billing practices of the medical flight industry. However, it now seems that it may be passed along with the COVID-19 relief bill. Politicians have intervened to get both parties to find a middle ground, but it has largely been unsuccessful. Both the industries have not budged from their stand but it must be noted that most medical flight service providers have tried to get into insurance networks in recent times.
What Will the Bill Do?
The Federal bill will prohibit medical flight service providers from charging the patients directly for their services in the event that they are out of the patient’s insurance network. This is mainly being done as any patient, during critical times, has no time to contemplate the choices. On the question as to what would happen when a patient wilfully chooses an out-of-network medical flight, he or she might have to pay out of pocket, but there are restrictions. The medical flight service provider can only charge the patient if the patient is given 72 hours to analyze the costs. The patient’s consent to use the services in such instances is also important. If the bill goes through, it could change the landscape of the medical flight industry.