Air Ambulance costs - Montana aims to do something about it

[Just Plain Ruff]

Thoughts, discussion Right or wrong?  

https://www.ems1.com/air-medical-transport/articles/227698048-Is-affordable-air-ambulance-transport-a-right/?NewsletterID=&utm_source=iContact&utm_medium=email&utm_content=Exclusives1LeftTitle&utm_campaign=EMS1Member&cub_id=usr_rYgxvJiMpoxX5g7Z

[Off Label]

Helicopters, cancer treatment, treatment of rare disease...it's the conundrum. The money has to come from somewhere and someone won't be happy when it comes from wherever they are. There are a couple of hospital based programs where I am that offer memberships of maybe 100 bucks a year and medically necessary transports are covered. These memberships are also honored by services in surrounding states. NFP hospital HEMS are able to absorb rulings like this better than free standing services.

Discretion with what constitutes necessary air transport might help a little.

 

My 0.02

Edited April 5, 2017 by Off Label

[Just Plain Ruff]

yes, discretion is a very very good option.

But one issue is this,  patients often don't have a choice, they get what they get.  Not really any other industry is this way.  Not saying thats a bad thing but in most other industries we have the ability to say, I don't like your price so I'm going with option B - unless you - option A can drop your price to meet option B's price.  

In my area the Helicopter service LifeFlight Eagle has a membership plan, for 65 bucks a year, it covers your entire family.  They take what your insurance pays and then the membership plan pays the rest.  you don't see a bill.  unfortunately, you cannot go retroactive and get it after the fact.  So unless you have it, you are on the hook for a possible 40K bill.  

It is up to us as providers on many occasions to use discretion and only call the helicopter when it's truly needed and not because the person has a membership plan (yes I've seen this happen countless times) or call them because the local small town hospital doesn't have a orthopedic surgeon and the patient has an isolated knee injury (yes I saw this as well - the medic didn't want to drive the 65 miles to the nearest ortho surgeon so she flew the patient).  The patient got stuck with the entire 35k bill because the entire flight was denied.  Even the membership plans have their denials.  

so as providers it's incumbent upon us to use the helicopters diligently and correctly.  

[paramedicmike]

Can a market like rural Montana tolerate much in the way of competition?  Especially as a means to keep prices in check?  Helicopters are, by nature, expensive to operate and maintain.  Safe air medical operations come at a financial cost. 

The same question can be made of health care in many communities.  Population density can only support so much.  Market factors can only support so much.

It is a conundrum as Off Label noted.  The money has to come from somewhere.  People want to have the service available, or at least the option of the service available, but understandably balk when the price tag is levied against them.  When it's your loved one, family member, or you(!), price isn't really what you're thinking about when the decision is made to use many aspects of health care.  Should it really be a consideration in a true emergency?

[Just Plain Ruff]

Mike, absolutely not, in my opinion, cost should not be a consideration and that is why I'm a complete and total advocate of these membership plans that many helicopter services have but then again, when many of the helicopter flights are proven to be non-medically necessary(i have many that I know of personally in my years in EMS) some of those membership plans do not cover those flights.  

My family is covered by two plans. one for the eastern portion of my state and the other for the southern.  We go to both areas on a semi regular basis and those areas are covered by completely different helicopter services.  

[rock_shoes]

I personally can't get over two particular lines in this article.

"Is health care a right of all Americans?"

"Or is it a privilege for those who can afford it?"

There's a reason the US is the only first world country without some form of bare minimum socialized healthcare. If basic healthcare isn't a right in your country it bloody well should be.

 

More on the topic at hand, the problem isn't HEMS cost so much as it's too many providers in the market. Multiple providers all scurrying for the same damn peanut creates an unsafe feeding frenzy clearly evidenced by the HEMS crash rate. Clear and concise training for ground crews as to when HEMS is appropriate alongside controlled provision of service on the part of the state. When a ground crew makes a HEMS request that request should go to a state dispatch centre with zero affiliation to any particular service provider. The state dispatch centre selects the most appropriate air resource and they're dispatched to the call. No crew shopping period.