Amid thundering engines and pounding heartbeats, crews of medical flights set out on life-saving missions every day. The mission starts even before the takeoff. The planning begins with choosing the right crew, the right aircraft, ground coordination, specialists – the list goes on. On long-haul flights, it is also about accommodating the crew members of the medical flights once they land in far off places. Accounting for all the eventualities is what makes a mission successful.
Medical Flights beyond Borders
It takes anywhere between 12 hours to a day to get appropriate permissions for medical flights to cross borders. Failing to achieve this, can result in unnecessary delays and administrative hurdles. When the patient is critical, such a waste of time is can prove to be the difference between life and death. The degree of difficulty in obtaining these permits varies from one country to another. It can cost anywhere between USD 50 and USD 400.
Security of Medical Flights
All said and done, there are always those rare instances where air ambulances have to take off, and the ground staff then has to quickly work towards obtaining the permits. Security is a prime concern in such instances, especially if the travel destination is politically volatile. Experienced medical flight service providers are well aware of such issues and are always prepared for them. They know the process and the people in the right places to make it happen.
Planning the Duration
Typically, air ambulances can be prepared to take off within an hour but these are always short-haul. For longer distances, it can take twice this time. Fuel, medical supplies, landing permits, etc. are part of the preparation.
Medical flights are usually called for emergencies. It takes an experienced crew to smoothly handle the unexpected. This includes the pilot and also coordinators during long flights.
Healthcare costs are not just about air ambulance costs. The United States of America has one of the highest healthcare costs in the entire world. An average American spends over 10 thousand USD in a year and the nation spends 3.3 trillion USD each year. This amounts to about 18 percent of the country’s GDP. Let alone the need for an air ambulance, a simple emergency room visit can leave a foreign national in huge debt. Hospitals simply do not release patients unless the care debts are paid out in full. A scenario like this can quickly turn a fun vacation into a financial nightmare, leaving the patient bankrupt.
A New Legislation May Necessitate Insurance
Although the legislation is primarily targeted towards immigrants to the nation, it is not entirely clear whether it applies to visitors to the nation as well. According to the new law, immigrants will have to purchase insurance for a period of 365 days or until such time that they stay in the country, whichever comes earlier. The move is meant to insulate the country from bearing high healthcare costs. In the face of this uncertainty, experts recommend that, regardless of the regulation, visitors must opt for comprehensive insurance.
A Policy that Covers Air Ambulance Services is Ideal
Not all visitors to the country arrive without insurance. However, many of them do not opt for adequate coverage. A slightly expensive premium can offer comprehensive coverage. Here is a scenario: you embark on a cruise during your visit. Unfortunately, you end up having a stroke. You will need to be flown to the nearest appropriate medical facility via an air ambulance service. The cost of this transport is going to cost quite a lot. The wise thing to do, therefore, is to explicitly ask your insurance provider about air ambulance coverage to stay safe.
Medical flight professionals function in an atmosphere of uncertainty today where what seems like an unknown illness can be a highly infectious disease, especially with the flu season and infections like Novel Coronavirus making rounds. In this context, how can they ensure their safety while caring for the sick? The question beckons some thought and also a few precautions to remain safe. Difficulty breathing, fever, and cough can be reason enough to take the precautions that we discuss below. The idea is for medical flight personnel to remain prepared to avoid any unforeseen eventualities.
Precautions to be Taken by Medical Flight Professionals
The foremost thing to do is to handle bodily fluids such as blood, vomit, and diarrhea with utmost caution. In this regard, hand washing is very important. Washing hands often when in contact with patients with respiratory difficulty is advisable. Soap is effective, but alcohol-based cleaning agent, which contains at least 60% alcohol is also advised. Care must be taken to not touch the nose, eyes, or mouth with unwashed hands. Medical flight professionals must make ample use of disposable gloves while handling patients. These must be disposed of carefully in biohazard bags. It must be kept in mind that hands are washed even after removing the gloves.
Other Precautions that are Necessary
In areas that are known to have even the smallest number of infected patients, medical flight professionals must make use of bodysuits that are certified to insulate from infections. Since it is suspected that Novel Coronavirus can be aerosolized, it is wise to wear a facemask as a form of protection. Also, the number of personnel coming in direct contact with the sick should be minimized, although it is impossible to completely eliminate this possibility. Most importantly, one should be well-versed with the precautions put forth by the CDC.
Drones have immense potential to augment the efforts of the air ambulance industry. They reduce costs, reach treacherous terrains, and function in risky situations. Thanks to modern technologies like cloud computing and Internet of Things, drones today are making advances in leaps and bounces. However, drones can be a menace too. Flying too close to air ambulances have caused many flights to be aborted midway and led to near-fatal accidents. The fact that such disturbances occur when carrying critical patients is an added insult to the injury. In other words, the air ambulance industry views drones with a mixed feeling. Here, we take a look at some recent developments that prove our point.
The Air Ambulance Industry is Trying to Tackle Stray Drones
Air ambulance industry experts say that, in the UK, drones are not allowed to fly over 400 feet. Failing to comply with this rule can attract fines of up to 1,000 British pounds. However, the problem is that air ambulances, most of the time, are compelled to fly below this altitude. With a growing number of hobbyists taking up flying drones, this is turning out to be a real danger for the air ambulance industry.
The only thing that medical flight organizations can do in this scenario is building awareness. Industry experts say that a good rule of thumb is to keep the drones in sight at all times. If the drone is not visible to the hobbyist, it is likely that it is disturbing a helicopter, likely a medical flight that is en route, trying to help a critical patient before it is too late.
A Full-Service Drone Company Takes Birth in the United States
There is also some good news for the air ambulance industry pertaining to drones. A company by the name Aquiline has come up with a drone that is capable of executing medical rescue operations. The company has developed a dedicated cloud environment and an operating system to make drone operations seamless.
In light of the above developments, it is safe to say that responsible use of drones will definitely help the air ambulance industry in the future.
It is believed that the medical flights will be in great demand for most part of the next two decades and will grow at a rate of 9.3%. In the past year, the industry grew to US$ 4,524.7 million. Those are some robust numbers and not the kind we commonly see in the prevailing economy. What are the driving factors behind these trends? It is certainly not the affordability of the people as evident by the growing concerns surrounding the balance bills that never fail to make the headlines. It is the medical need that is driving the air ambulance industry. Here are some sharp insights.
Medical Flights and Diabetes
Perhaps the most common lifestyle disease that prevails today is diabetes. While there is nothing that cries emergency about diabetes, it is a cause for more serious ailments. People with diabetes are known to eventually develop serious heart and kidney conditions, which give rise to life-threatening emergencies. This is where medical flights come into picture. With the US fighting obesity and diabetes (as a consequence), the market is set on an upswing. In fact, currently, there are about 463 million diabetics in the country, and it is projected to reach 700 million in the next 25 years.
Medical Flights and Drug-Related Emergencies
The illicit drug menace has bothered the country for long. Today, it is believed drugs are among the biggest killers when it comes to people under the age of 50. A lot of times, these give rise to serious and unexpected medical emergencies ranging from overdose to motor vehicle accidents. Medical flights are the only recourse in most cases.
Medical Flights and Rural Hospitals
It is a known fact that rural hospitals have been closing down at a rapid rate in the country, and the trend has been up since a decade now. Medical flights are the only way out for the residents of such areas.
In a way, the market for medical flights is a reflection of how healthy the society is.
The air ambulance industry has been in the headlines for quite some time now. Most recently, however, it was because the state of Wyoming was attempting to regulate it. The hurdle was (and is) a federal regulation that prohibits state governments from interfering in the affairs of air ambulance industry. However, the attempts were rejected by CMS. Wyoming had proposed that the states must be allowed a say in the matters of air ambulance industry. It had done so to keep the cost of medical flight services at bay as they have been getting steeply expensive recently.
Does this Mean the Air Ambulance Industry has Won?
The answer is “yes.” At least for now, the air ambulance industry seems to have won. The CMS verdict favors the medical flight service providers. They will not be subjected to any state control and will be free to fly across state borders and also charge the consumers what they feel is the right amount.
The industry had feared that if they are forced to come under insurance networks, they will then have to conform to the reimbursement rates that are set by the insurance organizations. This was especially worrying since the rates have not been revised in over a decade. Moreover, since bidding system to offer services for a particular state would have come into picture, there were high chances that some insurance companies would have gone out of business.
What does it Mean for Consumers?
Consumers will now have access to a wide range of air ambulance companies. This means they will be able to avail specialized medical flights during emergencies. Since the profitability will remain unchanged, the air ambulance industry would find it financially encouraging extending their reach to remotest parts of the country. There, however, is one drawback. Since insurance companies have not still revised their reimbursement rates, the consumers are at risk of high out-of-pocket expenses.
A recent survey has shown that medical flight services are now more open to insurance network participation. In fact, the numbers have gone up by a healthy 20%. It has also been seen that the medical flight services and insurance companies are holding intense discussions and negotiations surrounding in-network arrangements.
The reason behind this change has been the huge increase in consumer demand and also to steer clear of the negative publicity that both the industries have been subject to in recent times. The efforts by the state governments to regulate air ambulance pricing and also getting insurance companies onboard with their cost-controlling measures have seen a lot of backlash recently.
The Medical Flight Services and their Cost Compulsions
The refusal of the insurance companies to take cognizance of the fact that maintaining medical flight services is an expensive affair – some say – was the cause of all the misunderstanding. Air ambulance companies usually spend a fortune to remain on standby for emergencies. The cost, of course, is then transferred to their services. When insurance companies refuse to foot these costs, the burden unfortunately is transferred to the patients who avail the service. This is a practice that is popular as ‘balance billing’.
How In-Network Coverage Helps
Customers are able to enjoy discounted and ‘fair’ out-of-pocket expenses to cover medical flight services when in-network coverage becomes a reality. In an ideal world, all air ambulance services providers must be in-network. However, the onus of it does not lie only on these emergency service providers. The insurance organizations too must be willing to reimburse a fair amount. Otherwise, it simply does not make business sense for medical flight services to join any network.
The good news, however, seems to be that both these industries are coming around and finding common grounds to work together.
When it comes to communities funding air ambulance services, United Kingdom leads the way, and there is no doubt about it. It is the involvement of the locals that makes it happen. People are known to undertake several community efforts, no matter how small, to keep the medical flights funded. From marathons to selling cookies, people contribute in their own way through innovative fund-raising efforts. The question that such undertakings raise is this: does this method work across the board? The answer to this simple question, however, is quite complex and the success is dependent on several factors. Let’s take a look at some of them.
The Absence of Significant Private Air Ambulance Companies
In a country like the United States, there are several private players who do an exemplary job to provide air ambulance coverage. They span a wide network of rural areas with zero compromise on quality of transport. The problem, however, is the price that they charge. In the absence of adequate insurance coverage, they can turn out to be a huge challenge to pay off. Of course, there is the issue of network coverage and surprise billing that has got the country concerned lately. This is the prime factor that is pushing people to look at alternate means of funding air ambulance services.
Community Funding is Not Always Successful
The estimated cost of keeping air ambulance services floating runs over a million dollars. Even the most successful charitable medical flight services do not rely solely on community funding to satisfy this need. Governments and corporate organizations play an active role in their funding. Moreover, prominent personalities are known to raise awareness and extend support to raise awareness about the services. In the United States, however, such an ecosystem is completely missing. Unless there is a concerted effort to get it in, such efforts are bound to fail.
There has been much anticipation surrounding the new air ambulance bill that aims at curtailing surprise billing practices. However, experts opine that the draft leaves much to be desired for both parties – the payers and the air ambulance service providers. The feeling is that the lawmakers have tried to take a middle ground so as to not displease the air ambulance industry or the medical insurance industry.
From the insurance industry point of view, the fact that it suggests an in-network rate even for those medical flight service providers that are out of network seems like a big win. The provision is something that payers have wanted all along.
From the air ambulance industry point of view, the draft allows for arbitration if there is a dispute with regards to the billing. However, since this comes in the backdrop of a set rate, the industry is not too happy about it.
How is the Air Ambulance and the Wider Healthcare Industry taking it?
The American Hospitals Association has strongly opposed the draft. Their reasoning is that it harms the rural hospitals by limiting the access that patients currently have. The association went as far as saying it is a ‘windfall’ for the insurers ‘at the expense of’ community hospitals. American Association of Medical Colleges too has opposed the draft.
America’s Health Insurance Plans has displayed its dissatisfaction surrounding the provision for arbitration.
More about Arbitration
When it comes to air ambulance companies, arbitration will only be possible for amounts over $25,000. The industry is also expected to provide two years’ worth of data pertaining to costs. This data would be provided to US Transportation Secretary as well as HHS.
The air ambulance industry has been vocal in raising the concerns surrounding patient safety as well as closure of medical bases. They also pointed out that the current insurance payouts by Medicare and Medicaid do not cover even 40% of the costs.
There is no disputing the fact that the most important consideration when acquiring an air ambulance is the aircraft itself. However, once this is zeroed down upon, other considerations come into play. The prime among these factors is the interior of the aircraft. In this context, it must be borne in mind that aircraft manufacturing companies do not usually build one specifically for the air ambulance industry. They are designed for business. Once acquired, these aerial vehicles are then customized for medical transport. The following become the basic considerations for effective customization:
- Crew comfort
- Ease of access
- Ease of loading and unloading the patients
- Medical equipment accommodation
What Makes a Good Structure for Air Ambulance?
The entry, in other words, the cargo door, plays a vital role. The bigger this aspect is the better, as it facilitates easy on-boarding and off-boarding of patients. Cabin room is another factor that holds high importance. Since medical equipment needs to be kept handy during flights, cabin room matters. Plus, leaving just a little space for the patients and the crew is not advisable as it poses an operational challenge when the situation is critical.
Cabin floor is among the important factors. It is quite possible that the floor gets dirty during the course of patient care. Blood, bodily fluids, and even spillage of medicines are sometimes unavoidable. However, all these must be easily cleanable later as they can pose a health risk. Electrical outlets, high ceilings, fresh air distribution, low vibration, sound proofing are some of the other considerations.
While most of these factors can be customized post purchase, some aspects like low vibration and sound proofing are inherent features of an aircraft. More and more aircraft manufacturers these days are developing aerial vehicles that are meant specifically for the air ambulance industry. The change has come about due to the increasing demand.