Balance Billing Legislation Must Preserve Access To Air Ambulances

By Susan Connors and Carter Johnson

There’s a reason why you’re more extroverted than introverted. A reason why you’ve always preferred reading over math. There’s a reason why you look forward to that first summer ice cream cone – because it sparks a certain memory or makes you think of someone you love. Your personality, your likes and dislikes, and your memories are all unique to your brain. It’s what makes you you.

Now imagine if who you were changed in a matter of seconds. A brain injury can change the way a person thinks, acts, and feels, and it can happen in mere moments. Sometimes these changes are permanent, especially when individuals can’t receive the care they need after injury. The speed of treatment someone receives strongly influences the kind of effect their injury has on them and those around them.

This is why air medical services are critical when someone sustains a brain injury. Air ambulances not only save lives, but they are the best way to ensure that patients retain everything that makes them who they are. Air medical services rapidly transport patients to hospitals during emergency situations; they serve as flying ICUs, able to administer life-saving care in the air. This is especially important in America’s rural communities, where increasing hospital closures mean that patients may not have timely access to treatment.

Congress is rightly looking to address the bills some patients receive for emergency health care. However, as they look at myriad ways to ensure that no patients are stuck paying bills they weren’t expecting, it’s imperative they keep in mind the need for air ambulances across the country – especially when dealing with a brain injury. Private insurers must also make sure these services are covered.

The annual impact of brain injuries in the United States is significant. Every year, at least 3.5 million people suffer one. We are unable to predict how one’s brain may change after a traumatic brain injury. However, we do know that the sooner an individual receives specialized treatment for a brain injury, the better the likelihood of recovery. Strokes, seizures, motor vehicle crashes, falls, assaults, overdoses – all of these events cause brain injuries every day, and every moment counts when saving a life and preserving brain function. Air medical services can make all the difference.

Unfortunately, continued access to air ambulances across the country is under threat. While demand for air medical services has grown and operating costs have increased, Medicare reimbursement rates have not kept up. It’s been more than 20 years since Medicare reimbursement rates have been updated to reflect the true cost of care, and currently that only covers about 54 percent of the cost. Given that more than 70 percent of patients are either covered by Medicare, Medicaid, another form of government insurance, or have no insurance, air ambulances do not have the support they need to continue providing life-saving care and transport.

The other 30 percent of air medical transports are also not always fully reimbursed as some private insurance companies have pursued narrow networks or refused to pay for transport after the fact, which leaves the patients stuck with a bill they weren’t expecting and air medical providers struggling to continue providing care. While air medical providers are working to go in-network with insurance companies, some fail to negotiate reasonable contracts. According to one air medical provider, there has been a sharp decline in insured air medical transports of the past 10 years – 44% of emergency transports were for patients who held private insurance in 2007, but this number decreased to 30& in 2017. The effect of this under-reimbursement is already being felt across the country. Fifty-seven air medical bases closed in 2019 alone.

The Brain Injury Association of America and the Save Our Air Medical Resources campaign have a shared mission of preserving access to emergency medical care and supporting policies that improve the lives of those who have sustained brain injuries. As Congress debates how best to address balance billing, it must do so in a way that does not hinder access to vital air medical services that save lives. Air ambulances are instrumental in ensuring that the millions of Americans with brain injury have a chance of survival and a successful recovery.

Brain injuries are unpredictable, but having access to life-saving emergency care shouldn’t be. This Brain Injury Awareness Month, we urge Congress to support the access to care that individuals with brain injury need. Recovery itself takes enough brain power.

Susan Connors is the president and chief executive officer of the Brain Injury Association of America. Carter Johnson is the spokesperson for the Save Our Air Medical Resources Campaign.