Air Methods, the provider of the LifeNet helicopter ambulance based at Clarinda Regional Health Center, informed center officials this week the service will no longer be available effective immediately.
“It is hugely unfortunate,” said Clarinda Regional Health Center Chief Executive Officer Chuck Nordyke. The center has had the air ambulance since 2012. “How can we somehow salvage this? We’ve been talking to LifeNet for some kind of solution. They are open to figure out some kind of coverage, but it won’t be anything like it is now.”
According to a statement from Air Methods which oversees the operation, Air Methods will continue to cover the Clarinda area with other Air Methods operations: LifeFlight – UnityPoint, associated with UnityPoint Health in Carroll; LifeNet based in Omaha, Nebraska, and LifeNet in St Joseph, Missouri.
“In addition, Air Methods is working with all employees on opportunities for other positions within Air Methods or their next career steps,” Flanders said.
Air Methods is only used when called, and transports patient who needs the services, regardless of ability to pay.
“In many cases, we are the only link between hospitals for patients who need more intensive care, which is a responsibility we take very seriously as we make these decisions,” according to the statement.
Nordyke said when officials informed CRHC, the reason for stopping service was because of finances. Nordyke speculated part of the financial reason may be linked to how emergency medical services are reimbursed.
“I’m sure it flows to the flight side of things,” he said. “Those are major issues that need to be revamped. Iowa is working on it, but we need a solution, now, desperately.”
Air Methods provided a more detailed explanation.
“The cost of this around-the-clock readiness averages nearly $3 million per year for each air 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 base, giving companies little leeway in reducing costs on their own.
However, reimbursement for services has not kept up with costs. 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-transport reimbursement covers approximately half of the cost per transport, according to the AAMS study.
In Iowa, over 70% of our transports are Medicaid, Medicare, and self-pay/uninsured, which combined reimburses less than 30% of overall costs. Again, we don’t self-dispatch nor have any idea of insurance status until after we deliver our patient and finish our mission. Medicaid in Iowa pays $250 per patient transport, plus mileage, with Medicare covering around $6,000.
While we are seeing some progress in support for higher Medicaid reimbursement in Iowa, however, the lower payments by government payers in general means each Iowa air ambulance patient with private health insurance has to cover the costs for the remaining balance left by these 70% of transports. This business environment is not sustainable and puts emergency air medical transport access at risk, which is critical in a rural state like Iowa.
Fortunately, Air Methods is in-network with Wellmark Blue Cross Blue Shield, Avera Health Plans, DAKOTACARE, as well as the national Humana health insurance plan and more than 25 other in-network commercial health plan agreements across the country. We will continue 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.
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 of debt on private businesses,” according to the statement.
Clarinda Regional Health Center provided the landing pad. The helicopter’s fuel system and crew housing, also located on the center complex, are not owned by Clarinda Regional Health Center.
“We did not gain anything from having that service,” Nordyke said. “For a care standpoint, it was tremendous. We’ve always been happy with the partnership.”