Preserve Access to Air Ambulance Services in Missouri

By Wilmas, Dr John | St Louis Post-Dispatch (MO), May 15, 2018 | Go to article overview

Preserve Access to Air Ambulance Services in Missouri


Wilmas, Dr John, St Louis Post-Dispatch (MO)


Dr. Bill Jermyn had a vision for rural Missouri: extend the quality medical care delivered in urban Missouri to rural Missouri. During an emergency, health outcomes deteriorate when care is delayed. As the medical director for ARCH Air Medical Service, I know this all too well. Getting patients to the appropriate health care facility must be our top priority. Unfortunately, this patient access is threatened.

Nearly 90 percent of air medical patients are experiencing a serious cardiac, stroke, or traumatic event where time is of the essence. In many parts of the country, however, it takes more than an hour to get to a Level I or II trauma center by ground ambulance. Ground transports are even longer from rural areas, and the alarming trend of rural hospital closures makes things worse.

In Missouri, three hospitals have closed since 2010. According to the University of North Carolina Sheps Center for Health Services Research, 83 rural hospitals have closed nationwide over the last eight years -- a rate of almost one per month. For patients needing to get to emergency care quickly, these closures can be deadly.

Air ambulances fill this gap by providing the critical care that patients need during rapid transport, despite facing a two-pronged challenge.

As reported by the Post-Dispatch, after receiving life-saving air ambulance treatment, some patients end up with the bill because their insurance company will not cover the transport. Sometimes, the insurer underpays, or outright denies the claim because the air medical provider is out-of-network. At other times, the insurer second-guesses the doctor or first responder and denies payment based on their interpretation of whether or not air medical transport was necessary. In both cases, the insurer is in the wrong.

Covering air medical also makes moral and economic sense. According to testimony submitted to the Montana Legislature's Interim Economic Affairs Committee, Blue Cross and Blue Shield of Montana stated that covering air medical would add only $1.70 to a monthly premium. Contrast this with the cost of not covering air medical. Stroke patients, for example, have dramatically better health outcomes if they get timely appropriate treatment. If they don't and survive their stroke, they have longer hospital stays, more intense therapeutic regimens and enduring care needs.

There are two solutions. First, every insurance company should cover air medical, period. Every insurer should negotiate in good faith to bring air medical providers in-network and drop demands for contract language that gives them power to overrule medical decisions by doctors and first responders. …

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