Tuesday, October 19, 2021
HomeHealth CareAir ambulance charges rise for commercial insurers, but not for Medicare

Air ambulance charges rise for commercial insurers, but not for Medicare

Dive Summary:

  • Permitted In-network charges for fixed wing air ambulances increased 76% between 2017 and 2020, and now exceeds $ 15,000, a new study from Fair Health found. The median charge increased 27.6% over the same time period, to over $ 24,500 from just over $ 19,200. For helicopter transfers, the average allowable charge increased 60.8%, from just over $ 11,600 to over $ 18,600.
  • Meanwhile, the average Medicare reimbursement increased much less dramatically between 2017 and last year, representing only a fraction of what commercial insurers are charged for air ambulance transportation.
  • Demand can be part of the equation. Fair concluded that air ambulance claims increased 30% between 2016 and 2020. The main reasons for these transports are digestive problems, heart attacks and broken bones or fractures. The states with the highest volumes of fixed-wing air travel are rural: Alaska, Wyoming, South Dakota, Montana, and New Mexico. For helicopters, they are Idaho, South Dakota, New Mexico, West Virginia, and Wyoming.

Dive Insight:

The air ambulance industry has received significant scrutiny from state and federal regulators in recent years, as most rural patients suffering significant health problems or accident injuries often face huge bills that their insurers they often don’t pay. More than 70% of ambulance trips, both air and ground, subject those with medical insurance to a surprise bill. These practices will soon be outlawed under federal law that goes into effect on January 1.

However, the new Fair Health study indicates that even among insurers, charges have risen dramatically in recent years.

The average allowed in-network charge paid by insurers for fixed-wing transportation reached $ 15,624 last year, up from $ 8,855 in 2017.

The majority of patients requiring air travel are over 65 years of age. This cohort accounted for 55.4% of the air transport claims and 63.6% of the helicopter transport claims.

That means Medicare pays the majority of air ambulance claims, and that program appears to have controlled the rising costs. The median Medicare reimbursement for a fixed-wing transportation was just $ 3,216 last year. That was just 4.7% more than in 2017, when it was $ 3,071. Medicare also maintained strict controls on reimbursements for helicopter transportation. Their average refund was $ 3,739 last year, also 4.7% more than in 2017, when it was $ 3,570.

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