The May 2017 issue of Consumer Reports carries an article, also available on the magazine’s website, titled Air ambulances: taking patients for a ride. The piece begins with an example of a child’s family who are contesting the bill for an air ambulance helicopter flight they say their daughter did not need. It goes on to discuss safety, the rapid growth in the numbers of medical helicopters flying in the US, and the growth in for-profit operators, as well as giving advice on ‘battling unwanted bills’.
In its statement, AAMS argues that the main premise of the article (‘question your emergency doctor and first responders, but trust your insurance company because they know what is best’) is false. It adds: “Air medical providers do not self-dispatch and are only used when requested by medically-trained first responders or physicians, according to dispatch protocols developed by local emergency medical professionals, given the unique needs of regional health systems … They are trained to err on the side of caution. They are trained to err on the side of what is right for patient, not the patient’s insurance company. To do anything less would be putting a patient’s safety and well-being at risk.”
AAMS acknowledges that air medical transport is an ‘expensive service that should only be used when deemed necessary’, but says that the decision should be made by the medical professional at the scene, not by insurance companies.
The issue behind rising medical costs, says AAMS, is the inadequate coverage offered to consumers for their emergency care. The Association continues: “In many instances, insurers have negotiated fair in-network agreements with air medical providers. Unfortunately, fair negotiations are not always guaranteed. In those cases, patients with private insurance are sometimes stuck in the middle, when insurance companies don’t work with healthcare providers (including air medical transport providers) to hold patients harmless and negotiate fair payment schedules.”
Consumer Reports stated that Air Methods, PHI Air Medical, Air Medical Group Holdings and Metro Aviation, described as the four largest for-profit operators, accounted for 68 per cent of industry accidents from 2010 to 2016 (37 out of 54 crashes) but accounted for 51 per cent of the air transport market. Addressing the article’s claim that ‘for-profit air ambulance companies have a spottier safety record than non-profit operators’, AAMS says that while such companies do account for 68 per cent of accidents, they provide aviation services, either directly or by providing aviation services to hospitals, for over 90 per cent of the aircraft involved in air medical transportation.
The air medical industry has drastically improved emergency healthcare access since the implementation of the Medicare fee schedule, says AAMS, adding: “However, that growth has come in response to the closure of rural hospitals, the increased specialisation of hospitals, and increased population growth in suburban and rural communities. Recent studies show that current Medicare payments fall far short of covering the costs of providing the service, leading to higher prices for non-Medicare patients.”
AAMS offered a number of solutions to the issues facing air medical services and the patients they transport: reform Medicare reimbursement rates for air medical services through federal legislation; require cost and quality reporting mechanisms to provide industry transparency and better educate the public; and support existing federal laws that allow air medical services to transport patients to the closest appropriate facilities.”