Department of Transportation committee chartered to make recommendations to Congress about air medical patient billing practices
GREENWOOD VILLAGE, Co., Sept. 12, 2019 (GLOBE NEWSWIRE) -- Air Methods, the leading air medical service provider, today announced that Chris Myers, EVP of reimbursement, was appointed to the Air Ambulance and Patient Billing (AAPB) Advisory Committee, which was included as part of the passage of the FAA Reauthorization Act of 2018.
The committee will be responsible to inform Congress on the complex issue of air ambulance medical patient billing. In addition, the committee will provide recommendations to protect consumers from balance billing for air ambulances services, requirements for the disclosure of charges and fees for these services. The formation of this committee is a critical milestone as Congress considers next steps to find the best solution for consumers and the industry.
“The development of this committee and breadth of industry representation is confirmation from Congress and the Department of Transportation that all players in this industry need to work together to protect patients while also ensuring that air medical services can continue to provide critical life-saving services to patients in need,” said Myers. “By working with key stakeholders from various parts of the industry, I am confident that we can all start to understand each others’ perspectives but more importantly to develop creative solutions to protect patients.”
According to 2019 Government Accountability Office report, approximately 70 percent of air medical missions completed in 2017 for patients with private insurance were out-of-network, which is higher than any other emergency services. The AAPB Advisory Committee will evaluate data about current costs for air medical services and current complaint information to provide recommendations for more transparent consumer disclosure.
As Air Methods is leading the way in going in network with health insurance providers, Myers’ inclusion in this committee will provide additional context and insights from the air medical provider perspective. As an organization, Air Methods supports requiring greater cost and data transparency, updating the Medicare reimbursement rate, and having state insurance regulators taking a closer look at the root causes of large balance bills, including narrow networks and medical necessity denials. Air Methods is committed to continuing to work with all stakeholders to find a favorable set of recommendations that alleviates the balance billing issue currently faced by patients while ensuring air medical services are fairly compensated so as to provide this valuable service across the nation.
Current Reimbursement Models are Not Sustainable
The cost of around-the-clock readiness that air medical bases must maintain averages nearly $3 million per year for each air medical base, according to a cost study prepared for the Association of Air Medical Services (AAMS). Further, approximately 85 percent of costs are fixed costs associated with operating an air medical base, giving companies little leeway in reducing costs on their own.
However, reimbursement for services has not kept up with costs. Reimbursement for seven out of every 10 missions does not cover the cost, according to the AAMS. Medicare, which covers air medical services in emergency cases only, established the current air medical service payment rates in 2002 based on an estimated 1998 cost pool. Today, the average Medicare per-mission reimbursement covers approximately half of the cost per mission, according to the AAMS study.
Because of the high number of uninsured patients across the country and the low payments by government payers, each air ambulance patient with private health insurance has to cover the costs for the remaining balance left by these 70% of missions. This business environment is not sustainable and puts emergency air medical access at risk, which is critical as more than 85 million Americans can reach a trauma-1 or -2 facility in less than an hour only if they travel by air – a number that is only expected to grow as more rural hospitals are shuttered.
To continue to alleviate the financial stress on patients, Air Methods has continued to aggressively pursue payer agreements across the country so that patients have access to discounted, out-of-pocket payment for qualified services, which varies depending on their plan’s benefits. Currently, Air Methods has more than 27 Blue Cross Blue Shield health plan agreements across the country plus the national Humana health insurance plan. Today, more than 70% of the U.S. population is in-network between Medicare, Medicaid and commercial insurance. Additionally, Air Methods’ Patient Advocacy Program helps patients navigate the insurance billing and appeals process and provides them with the information they need to come to a financially sustainable resolution to their claim. On average, patients that work with us pay a couple hundred dollars out of pocket, which include insurance co-pay and deductible.
However, if the low government reimbursement continues, businesses will be deterred from providing this critical service that is needed. The best solution is to increase Medicaid reimbursement at the state level and the federal government to increase Medicare reimbursement for air emergency services which will ensure that the government doesn’t place this burden on private businesses.
About Air Methods
Air Methods (www.airmethods.com) is the leading air medical service, delivering lifesaving care to more than 70,000 people every year. With nearly 40 years of air medical experience, Air Methods is the preferred partner for hospitals and one of the largest community-based providers of air medical services. United Rotorcraft is the Company’s products division specializing in the design and manufacture of aeromedical and aerospace technology. Air Methods’ fleet of owned, leased or maintained aircraft features more than 450 helicopters and fixed wing aircraft.