For Brain Injury Patients, Air Ambulances Are a Life Saver

By Susan Connors and Christina Kanmaz

March is Brain Injury Awareness Month, the perfect time to draw attention to the fact that, whether you realize it or not, you probably know someone who has experienced a brain injury. In fact, 5.3 million people in the U.S. lives with a permanent brain injury-related disability. That’s one in every 60 people. And while there are numerous causes, from strokes and seizures to drug overdoses and car accidents, one thing remains consistent – the faster care is provided, the better an individual’s chances of surviving the injury and preserving brain function.

That’s why air ambulances play a critical role in responding to the emergencies that precipitate both traumatic and non-traumatic brain injuries. And because air medical flight bases maintain 24/7/365 readiness, they can be deployed at a moment’s notice to transport individuals who have experienced a car crash, drowning, snowmobile accident, stroke, seizure, or other medical emergency, to the nearest emergency room or trauma center all while providing desperately needed care. This rapid response by air ambulances that are equipped like flying ICUs and staffed with highly trained medical professionals can lead to improved outcomes for patients.

At least 2.8 million people sustain a traumatic brain injury (TBI) each year. When it comes to treatment and recovery, the best facilities for these patients are trauma centers because they can provide continuous neurosurgical care. Unfortunately, 180 hospital closures in rural areas since 2005 have left millions living an hour or more away from the nearest Level 1 or Level 2 trauma center. Continuing financial pressures and the impact of the coronavirus pandemic have left another 450 rural hospitals at risk of shutting their doors. Protecting air ambulance services will help preserve the health of millions of Americans in rural communities and improve the outcomes for those in rural American that sustain brain injuries. To preserve the industry, air medical providers must be reimbursed fairly and equitably for their services by health insurers.

For far too long, many of the large insurers have kept independent air medical providers out of their networks to protect their bottom line, while leaving patients with the bill. They’ve even maintained narrow networks throughout the pandemic, despite the fact that air ambulances have transported more than 20,000 COVID-19 patients while insurers continue to enjoy huge profits due to low medical utilization rates.

Fortunately, Congress passed the No Surprises Act of 2020, which removes patients from the middle of billing disputes. Instead of patients receiving a balance bill, billing disputes between providers and insurers will now be settled through a process known as Independent Dispute Resolution (IDR). The IDR rules and protocols have not yet been established, but it is essential that the process is fair and equitable to protect patients and ensure the vitality of the emergency air medical industry. Without proper reimbursement, air medical bases are forced to cease operations – in fact, 58 bases have closed since 2019 due to cost pressures of low reimbursement rates.

To that end, the Medicare and Medicaid reimbursement rates must also be updated. Over 70 percent of all transports are for patients who have Medicare, Medicaid, or other government insurance, or who are uninsured. The reimbursement rates under these programs fall dramatically below the true costs of providing service – the average Medicare reimbursement only covers 50 percent of actual transport costs, and in many states, Medicaid covers far less (as low as 1/25 of Medicare in some states). The Centers for Medicare & Medicaid Services should collect cost data from air medical providers and use that information to appropriately update the reimbursement rates.

Someone in the U.S. sustains a brain injury every 9 seconds. These events happen without a moment’s notice, and for years air ambulances have been there to provide patients with life-saving services. As anyone who owes their life to the swift transport of an air ambulance will tell you, this is not an industry we can afford to lose. But without establishing fair and proper reimbursement rates, it’s a risk we face.

Susan Connors is the president and chief executive officer of the Brain Injury Association of America. Christina Kanmaz is the spokesperson for the Save Our Air Medical Resources (SOAR) Campaign.