To The Editor:
Recently, New York Assemblyman Will Barclay wrote a column (Dec. 4, Legislation Seeks to Protect Patients From High Air Ambulance Costs) about his proposed model legislation that would impact air ambulance services and the patients they serve.
As noted, many communities, particularly rural, rely on air ambulances to get to the closest hospital that could be hours away by drive.
When medical emergencies strike, time is of the essence and getting the appropriate care as quickly as possible can save lives. When first responders or physicians call for an air ambulance, providers respond immediately without regard to a patient’s ability to pay – safe transport and lifesaving clinical care is their priority.
We agree that patients should not be stuck in the middle with huge bills.
While the Assemblyman’s proposal seeks to address the financial burden insurance companies sometimes place on patients when they don’t fully cover emergency care, it unfortunately fails to address the underlying problem: inadequate reimbursement rates.
Today, seven out of 10 air medical transports are under-reimbursed.
The average Medicare reimbursement covers less than 60 percent of actual transport costs. In some states, Medicaid reimbursements can be as low as $200, which is less than half of the price of fuel alone for the average transport.
The result is extreme cost shifting onto remaining 30 percent of patients.
This is not sustainable, and must be addressed if we are to preserve patient access to emergency air medical services.
Like the Assemblyman, we fully agree that the federal government needs to take action.
That’s why we’re supporting the Ensuring Access to Air Ambulance Services Act (S. 2121/H.R. 3378).
This bipartisan legislation would update Medicare reimbursement rates to ensure they reflect the true cost of service today, and take significant steps to relieving the unsustainable cost-shift on those with private coverage.
We applaud the Assemblyman’s commitment to these lifesaving services and urge him to support this bipartisan legislation.
Carter Johnson, spokeswoman, Save Our Air Medical Resources (SOAR) campaign (www.soarcampaign.com)
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Yes, our Air Medical resources are a critical component of our emergency medical services system, nationally as well as in NYS.
However, not all (and in fact, today few) of the air medical services providers are the altruistic community services providers they might make themselves out to be. Today, a large percentage of air medical services are provided by for profit corporations, often under significant pressures to be profitable,and when profitable, very profitable.
The author of the article above failed to disclose the fact that he is in fact (most likely, considering the number of google results) a corporate lobbyist & consultant for Air Methods corporation, one of the largest private, for profit air ambulance providers in the US. Air Methods was recently acquired by a private equity firm on Wall St. Air Methods is the parent company of Lifenet, a for profit air ambulance provider with 10 bases in NYS.
In the pursuit of profits, Lifenet of NY (owned by Air Methods) has proceeded to open a total of 10 locations across NY, often acquiring or assuming operations of flight services of at least a couple of major NYS Trauma Centers. Several of these locations have overlapping service areas of both other Lifenet bases as well as those of other services.
Lifenet has replaced or is trying to replace services provided by Westchester Medical Center (STATFlight), Albany Medical Center (Medflight), the New York State Police have significantly curtailed their air ambulance operations, and Lifenet is or has placed helicopters in areas currently served by other providers (MercyFlight).
For profit air ambulance companies often refuse to negotiate rates with insurance carriers to a mutual agreement. This results in significantly reduced coverage due to “out of network” status, increasing the burden on patients.
Additionally, air medical services are often over utilized in the US, resulting in unnecessary flights, and unneeded costs. Emergency Medical Services (particularly in rural areas) in NYS are often provided by volunteer providers, whom may go through the same training classes as their urban counterparts, may not have the same experience level and exposure to call volumes that their urban/suburban counterparts do. This can easily result in very well intentioned providers making very defensive calls for a helicopter to the scene of a call. You very well could have an 18 year old a couple of weeks or months out of a hundred and fifty class making the decision to incur a $65,000 expense out of an abundance of caution.
If the viability of air ambulances in NYS requires surprise bills, over saturation of services, refusal to negotiate with insurance providers and a litany of other complaints filed nationally against for profit air ambulance providers then it is time to rethink the viability of allowing for profit providers to manage, control and profit from these critical events.
Air ambulance (and Air Methods in particular), has raised outrage nationwide at their fee structure and billing practices. Simply Google.
There are a variety of other funding mechanisms for Air Medical services that can decrease the per flight costs and reduce the burden on patients that for profit air ambulances can cost. Until recently, neighboring NJ had nearly all of their air medical services provided by the NJSP (a for profit hospital chain thought the opportunity profitable enough to sue over the right to operate their own service). In Maryland, there is statewide fee free air ambulance service provided by the Maryland State Police, funded through vehicle registration taxes. In Florida, many counties operate their own AIr Ambulances through county sheriff’s offices or Fire Departments. Monroe county, FL (the FL Keys) recently began operating their own county based air ambulance service due to resident objections and issues with Lifenet’s billing practices.
Do not fall for the lobbyist trick of associating the risk to their profits to your safety. Nationwide, many studies published in major national publications have indicated that the proliferation of for profit air ambulance services has in fact resulted in significant over utilization of their services, as well as increased safety hazards.
One analysis I have read conducted by Consumer Reports indicated that the largest 4 for profit services (Air Methods, PHI, Air Medical Group Holdings and Metro Aviation) were involved in nearly 70% of safety incidents (i.e. crashes), despite only flying 51% of flights during 2010-2016.
Save Our Air Medical Resources??? More like save our profit margin…