Most Patients Undergoing Ground And Air Ambulance Transportation Receive Sizable Out-Of-Network Bills

Chhabra, Karan R.; McGuire, Keegan; Sheetz, Kyle H.; Scott, John W.; Nuliyalu, Ushapoorna; Ryan, Andrew M.

doi:10.1377/hlthaff.2019.01484

Cited by 29 publications

(33 citation statements)

References 8 publications

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“…1 And charges in other situations can also be high. For example, for patients undergoing surgery with in-network surgeons at in-network facilities, the mean potential balance bill was $1,219 from anesthesiologists and $3,633 from surgical assistants (Chhabra et al 2020b).…”

Section: The Problem Of Surprise Billsmentioning

confidence: 99%

The No Surprises Act: A Bipartisan Achievement to Protect Consumers from Unexpected Medical Bills

Hoadley

Lucia

2021

Journal of Health Politics, Policy and Law

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The No Surprises Act, passed by Congress at the end of 2020, offers significant protections to most Americans with private health insurance. Insured Americans are vulnerable to receiving surprise medical bills when they receive services from out-of-network providers. Protections for consumers against such bills initially emerged in several states that passed laws. The varying approaches taken in different state laws ultimately offered a foundation for federal legislation. Although there was always a broad consensus among stakeholders for protecting consumers during both state and federal deliberations, it was a challenge to identify a means of determining the amount that an insurer should pay to the out-of-network provider. But the Congress eventually reached a compromise that became law, which goes into effect in January 2022.

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Section: The Problem Of Surprise Billsmentioning

confidence: 99%

The No Surprises Act: A Bipartisan Achievement to Protect Consumers from Unexpected Medical Bills

Hoadley

Lucia

2021

Journal of Health Politics, Policy and Law

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“…The cost of unnecessary transfers also places a burden on our patient population for both the uninsured and the insured patient. The average cost of ground transport nationally is $1000, while the average cost of air transport is closer to $40,000 9 . One 2020 study showed 71% of insured patients were charged out-of-network costs for their ground transportation costing an additional $450 more than in-network costs.…”

Section: Discussionmentioning

confidence: 99%

Trauma transfers discharged from the emergency department—Is there a role for telemedicine?

Lindsey¹,

Rasmussen²,

Hendrickson³

et al. 2021

J Trauma Acute Care Surg

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BACKGROUND:As the only Level I trauma center in the state, our hospital has seen an increase in the number of traumas requiring transfer for a higher level of care, placing strain on an already strained health care system. Traumas that are transferred to our facility and subsequently discharged back home indicate a subset of patients who may not be appropriate to transfer. The aim of this study is to identify commonalities between patients who were transferred for a higher level of care but do not require inpatient status and to assess patients who may benefit from a telemedicine evaluation. METHODS:A 2-year retrospective review of a prospective collected database of patients who were discharged from the ED following transfer to a Level I trauma center was conducted. Data included demographics, injuries, transferring facility, method of transport, activation criteria and level, additional imaging, consulting services, procedures, and disposition. RESULTS:A total of 2,350 patients were transferred. Of those, 27% (632/2,350) were discharged home directly from the trauma bay. Of those patients, 36% (230/632) required complex bedside intervention or subspecialty consultation prior to discharge including complex laceration repairs 53%, ophthalmology examination 24%, splinting 18%, and joint reduction 5%. Sixty-four percent (402/632) of patients did not require complex bedside procedures prior to discharge. One hundred twenty hospitals transferred patients to our center during this period. The top 10 transferring facilities accounted for 40% (948/2,350) of our transfer volume. CONCLUSION:Our study demonstrates that patients who are transferred to our facility and subsequently discharged have a common pattern of injuries; typically, isolated hand and face/ophthalmology. This is likely attributed to the lack of resources in rural facilities to evaluate and develop treatment plans for these injuries; however, only 36% of discharged patients required a bedside procedure. Excluding Level I traumas, head and spine injuries, and patients requiring complex bedside procedures, there was a 13% inappropriate rate of transfer (310/2,350). Development and implementation of a telemedicine system could potentially reduce the transfer and ED discharge rate, thereby improving efficiency and allowing for reallocation of resources as appropriate.

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“…The financial cost of air medical services care and transport can be significantly higher than similar care provided via ground EMS. (112,131) Some of the differences in cost of care delivery can be attributable to higher operating costs for aircraft versus ground vehicles, higher wages for the higher skill level of some clinicians, and lower utilization ratios for air medical services. Another reason for the fee difference in equivalent care between air and ground EMS is that ground EMS billing and reimbursement is restricted by federal programs that limit the amount that can be billed and/or reimbursed for various levels of EMS care and that restrict operational cost recovery to a flat per-loaded-mile rate.…”

Section: Economic Factorsmentioning

confidence: 99%

“…Rather, utilization review should carefully consider whether the personnel requesting an air response did so appropriately in the context of their training and experience, whether established utilization criteria or algorithms were followed, whether validated scoring systems and decision tools were applied, or if advice was sought from regional coordinating centers or from EMS physician oversight. (49,131)…”

Section: Utilization Review and Quality Assurancementioning

confidence: 99%

Appropriate Air Medical Services Utilization and Recommendations for Integration of Air Medical Services Resources into the EMS System of Care: A Joint Position Statement and Resource Document of NAEMSP, ACEP, and AMPA

Lyng

Braithwaite

Abraham

et al. 2021

Prehospital Emergency Care

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Air medical services involves providing medical care in transit while using either fixed wing (airplane) or rotor wing (helicopter) aircraft to move patients between locations. The modern use and availability of air medical services has expanded access to various health system resources, including specialty care. While this is generally beneficial, such A c c e p t e d M a n u s c r i p t expansion has also contributed to the complexity of health care delivery systems.(1, 2) Since the publication of the 2013 joint position statement Appropriate and Safe Utilization of Helicopter Emergency Medical Services,( 3) research has shown that patient benefit is gained from the clinical care capabilities of air medical services independent of potential time saved when transporting patients.(4-6) Because the evidence basis for utilization of air medical services continues to evolve, NAEMSP, ACEP, and AMPA believe that an update regarding the appropriate utilization of air medical services is warranted, and that such guidance for utilization can be divided into three major categories: clinical considerations, safety considerations, and system integration and quality assurance considerations.

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Most Patients Undergoing Ground And Air Ambulance Transportation Receive Sizable Out-Of-Network Bills

Cited by 29 publications

References 8 publications

The No Surprises Act: A Bipartisan Achievement to Protect Consumers from Unexpected Medical Bills

The No Surprises Act: A Bipartisan Achievement to Protect Consumers from Unexpected Medical Bills

Trauma transfers discharged from the emergency department—Is there a role for telemedicine?

Appropriate Air Medical Services Utilization and Recommendations for Integration of Air Medical Services Resources into the EMS System of Care: A Joint Position Statement and Resource Document of NAEMSP, ACEP, and AMPA

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