The United States has one of the largest air ambulance industries in the entire world. This is in spite of the fact that it is not the most densely populated country in the world. It is, therefore, natural that one wonders why this is so. There are several reasons behind it. One of the prime reasons is the potential for revenue. However, there is another important aspect to it, which is not often considered. The United States is a country that has a huge rural population. It is without quick access to appropriate medical facilities and air ambulance services are a necessity.
Air Ambulance Services Close the Distance Gap
Although the United States is not a densely populated country, it is one of the largest when it comes to the landmass. This means that the population in the country is spread thinly across a large geographical area. Moreover, the cities are very thickly populated, which means the population in the rural areas is thinly distributed. This fact acts as a disincentive for any major medical corporation to have a facility in the areas as the number of potential revenue-generating subjects is very not that great.
Air Ambulance Industry is a Profitable One
Closing the gap created by the lack of medical facilities in the rural areas is the air ambulance industry. Most of the time, the only way a patient can get quick access to advanced medical care is through air ambulance services. This fact increases the customer base of the industry. With most of these organizations being funded by private equity, obviously, a lot of investment has gone into the sector. The result has been a huge increase in the number of air ambulance services that rule the country’s skies. With the surprise billing practices slated to come to a close soon, the general public will soon reap the true benefits of having several air ambulance companies at their disposal.
If there is one thing that’s constant about medical flights, it is the fact that the industry is continually reinventing itself. From electric medical flights that are capable of vertical takeoff to dashboards that keep the crew updated with all the information they need during the flight, the sector is full of innovations. However, these innovations bring along something that the industry and its consumers do not desire, and that is the increase in costs. Balancing costs and enhanced efficiency is something that the industry has grappled with for quite some time. The question that arises is whether the innovations are proving too expensive for the industry.
The Rising Cost of Medical Flights has been a Long-Time Concern
The cost of medical flights never fails to make headlines. When middle-class families get slapped with huge air ambulance bills, eyebrows are naturally raised. The insurance coverage is often non-existent or so scant that they fail to cover the costs.
Innovations, in the midst of all this, can prove to be an added cost burden discouraging the industry to go ahead with them. Contributing further to it is the training and adaptation cost that adds fuel to fire. Then, what is the solution?
Rethinking the Least Likely Spaces
Fuel is one area that is a money burner. Aviation fuel does not come cheap. Moreover, the fuel itself is heavy, which translates into a need for more fuel to carry it. What if a predictive technology can be innovated to maintain optimum fuel levels? The other area is the material that goes into building the medical flights. What if the material that is lighter and less friction-causing is innovated? The list goes on. Of course, the focus needs to be trained on affordability.
All the research should ideally be funded by governments, communities, and corporates together with industry leaders. A model like this can truly take the costs in the right direction.
According to one research medical flight services run by for-profit organizations had seen, on average, 7 to 8 crashes a year between 1998 and 2012. Of these mishaps, the biggest contributors were those organizations that ran the most medical flights. This raised serious concerns about the safety norms followed by the industry and several studies and investigations were performed simultaneously to make the skies safer for the crew and the patients. The result was some startling revelations. It was seen that the crew was pressured to make as many flights as possible in a day to maintain the profitability of the organizations that they worked for.
What Were the Medical Flight Services Doing?
It was seen that medical flight services were taking orders for new rescue missions even during an ongoing mission. This caused unnecessary operational chaos and instilled a sense of urgency among the crew members. Moreover, it was seen that ground ambulance paramedics were being hired by medical flight services too. This was causing a conflict of interest, wherein the possibility of the paramedics contacting their favored service providers was high. It was also found that some so-called rescues were actually unnecessary as they did not provide any advantage over the ground transportation.
New Safety Laws were Passed
The medical flight industry was subjected to intense scrutiny. Certain safeguards such as maximum permissible hours of work for crew members and laws concerning visibility were put in place. The aging aircrafts had to be replaced by new and safer ones. Upgrades with respect to technology were also made compulsory in certain areas. Better weather reporting and aids for in-flight decision-making were put in place. It can be stated, with confidence, today, that medical flight services are safer and more efficient. The industry and the patients that it serves have benefitted immensely from these developments.
The air ambulance industry has seen several technological advancements in recent times and so have drone designs. However, it is noteworthy that there are not many drones being used in the civilian space meaningfully. Of course, drones are being used in the military space extensively and with high success rates. What is stopping drones from entering the air ambulance industry? This is a question that naturally arises. In this context, it must be noted that it was the military that first adopted medical flights, which eventually became what we refer to today as the civilian air ambulance industry.
What will it Take Drones to Enter the Air Ambulance Industry?
Military drones usually function in no-man zones in war-torn or border areas where there are not many obstructions. They have a fixed task and a fixed target. There is a huge support system on the ground that adds to the functionality of the drones. However, this is not yet the case with the air ambulance industry. Looking at it from a civilian perspective, most of the drones would need to function in areas that are teeming with people, vehicles, and urban infrastructure. These translate into obstacles. Navigating through them is easier said than done.
Obstacle Avoidance is Key to Success
What if the drones are able to avoid obstacles on their own without the need for external interference? A sensory advancement like this can make a huge difference. Come to think of it, the feat is not impossible, especially considering the fact that this is precisely what autonomous vehicles do.
Of course, navigability is another issue. The ground controls that can remotely monitor the drones are limited by range. While satellite controls can be brought into the picture, the danger of misuse of such technological access looms large. The need, therefore, is for a middle ground where safety and efficiency are both ensured. For now, it is a game of wait-and-watch.
Medical flight membership programs have always been around, although not many have been very popular. Now, with the regulations surrounding surprise medical bills, medical flight service providers are thinking of new ways to stay afloat. Will this mean that membership programs will be redesigned by most of them? It is a question that has remained unanswered, but something that the industry must look at closely.
The disconnect between medical flight service providers has been that they do not honor each other’s memberships. This leaves the members with limited options, wherein they are confined to availing services only from a few medical flight services. In emergencies, they may end up hiring any air ambulance service.
Will the Medical Flight Service Providers Come Together?
This is a big question that has remained unanswered so far. However, the medical flight industry has much to gain if this becomes a reality. Imagine how convenient it would be if one membership would cover all the medical flight services across the country and even across borders. Members simply would not have to worry about the cost. All they would need to do is pay an annual membership fee and the whole family would be covered.
Will Memberships Continue to Remain Popular?
It is likely that medical flight membership programs will gain in popularity. This will be the case even if there is an end to surprise billing. The reason is this: non-emergency medical flight services may still demand out-of-pocket payments. Having a membership can negate this issue. It is for this reason that medical flight memberships will continue to retain their utility. Plus, with the pandemic still not under control, air ambulances can come in handy, especially if it involves flying huge distances for appropriate treatment. The one factor that will continue to retain focus is the acceptability of memberships across service providers.
Technology has taken over almost all parts of our daily lives today, so it is no surprise that the air ambulance industry is evolving technologically. However, most of the changes have been focussing on making the flights safer and the equipment more effective. What about the information that the air ambulance crew handles every day? There has not been significant progress in this realm. Most of the information is exchanged via paper even today. It must be pointed out that some of the information is shared electronically, but there is a problem. The information sharing is mostly scattered and there is no one-stop solution to it as of now.
Electronic Flight Bags can Transform Air Ambulance Functioning
From standard operating procedures to weather forecasts, there is a sea of information that the crew needs to be aware of during each flight. Wouldn’t it be great if all the relevant information is found under one umbrella? Electronic flight bags can do the trick. A well-connected device that brings all the information under a dashboard is the ideal solution. The information needs to be dynamic as factors such as weather can change constantly. The ecosystem can be interconnected to several sources through a centralized data cloud.
What are the Limitations?
The air ambulance industry is highly regulated. Therefore, the electronic flight bag system would need approval from the relevant authorities and will need to remain in compliance. Then, there is the issue of connectivity. Without continuous connectivity, no cloud system works efficiently. With the air ambulance services often operating in remote areas, wireless internet connectivity can be an issue. Also, uniformity in sharing the data needs to be there so that all the systems involved speak to each other in a common language to avoid misinterpretation, duplication, or omission of critical data.
Despite all the limitations, it is hoped that the air ambulance industry will overcome them in the interest of smoother and more efficient operations.
The COVID-19 situation has caused a lot of problems throughout the country. The treatment expenses sometimes are very huge and the need for treatment highly urgent. A family from Central Florida was in one such situation. A family member had contracted the COVID-19 infection and was on a ventilator. The hospital that he was being treated had conveyed to the family that the patient needed to be transported to a more appropriate facility. The family had then contacted a medical flight company to transport the patient. The cost of the flight was going to be over USD 16,000 and the medical flight company had helped the family set up a GoFundMe page.
The Medical Flight Service was Not Availed by the Family
There are two versions that are currently going around. The family, on its part, revealed that they had canceled the medical flight due to certain apprehensions and the constant demand from the medical flight company for funds. They had arranged for another air ambulance service and had conveyed it to the first company. However, they later found that about USD 8,000 was withdrawn from the fund by the medical flight company.
The Version of the Medical Flight Company
The medical flight company said that the family was insisting that the patient be transported despite the treating physician not giving permission to do so. For this reason, the flight had to be rescheduled. Further, this had gone on for quite a few days. They revealed that, ultimately, they had got a text message that they no longer needed the medical flight service and the patient’s family had stopped responding to their attempts at communication. In fact, the air ambulance company had already arrived, ready to transport the patient when the cancellation was conveyed through the text message. Due to this, the air ambulance company had charged the family USD 8,000.
Customization has been a need of the air ambulance industry for a long time now. The customizations, however, have been mainly aimed at internal modifications to make maximum utilization of space. Another set of redesigns have come in the form of changes to the medical equipment with the objective of making them lighter and compact. As a result, the air ambulance vehicles that we see today are equipped with medical gadgets that can put regular intensive care units to shame. However, the industry is demanding even more, and rightly so. Offering premium services is what the air ambulance industry has strived for.
Air Ambulance Design Basics Need Change
The aircraft industry is highly evolved today and is looking to implement innovations. It is now looking at the air ambulance industry to spread its market reach further. It is a win-win situation for both industries.
For the aircraft manufacturing industry, it is a chance to widen its market as the traditional markets have seen a sharp slump in recent times. The COVID-19 situation has only worsened the existing situation. On the other hand, the air ambulance industry has had its own design demands.
What does the Air Ambulance Industry Need?
Efficiency when it comes to space is perhaps the biggest demand of the air ambulance industry. To make a true difference, medical flight designs need a fundamental change in design. The aircraft need to be lighter, yet more space-efficient.
Another requirement is maneuverability. The design needs to be such that an air ambulance must be able to land and take off amid heavy traffic. The ability to reach tough terrains is another requirement.
When achieving all this, the aircraft needs to be silent enough so that the patients are offered a comfortable flight. It is heartening to see that innovations in this space today are moving in the right direction.
Although the congressional bill that seeks to ban surprise billing is not limited to the medical flight industry, much has been made out about it. The bill will span the entire medical industry including doctors and medical service providers. Since the bill is Federal, it will apply to the medical flight industry too. However, this long-drawn bill was seen as a battleground with insurance providers on one side and the rest of the medical fraternity on the other. Who won the battle? This was the question that most people were asking at the end of it all.
It was a Balanced Bill with No Defeats
The main source of contention was the fixing of prices for various medical services. The insurance industry was bent on fixing it according to their prevailing rates, which, frankly, were outdated. On the other hand, the medical fraternity, including the air ambulance industry, wanted the government to consider its price list. However, it was widely believed that the list consisted of highly inflated prices. Realistically, it was never expected to be accepted even by those who were advocating it. The congressional bill has skilfully navigated between the industries to ensure that all involved parties get a fair deal.
Medical Flight Services Get the Option for Arbitration
The dispute about medical flight bills has always been between the insurance and the air ambulance industry. However, common citizens have borne the brunt of it. Now, however, the bill will introduce a mechanism for arbitration between the two parties so that they can sort it between themselves and leave the patients out of it. This will ensure that no patient gets a surprise medical flight bill even if the provider is out of network. The bill goes on to suggest protection for those without insurance too, in case of health emergencies. The way forward, it seems, is coming to a consensus for both industries.
The air ambulance industry, for the most part, had been opposed to the recently passed bill by Congress that seeks to put an end to surprise billing practices. The state governments in the United States have been on a long and hard-fought quest to curb surprise billing practices. However, since the air ambulance industry is protected by federal law, states were helpless in controlling their billing practices. This fact has now changed and brought along new challenges for the air ambulance industry. Most of the players in the medical flight industry are private-equity based and have largely remained out of insurance networks. The new bill can hit them hard.
Effect on the Air Ambulance Industry
Maintaining air ambulance services is no small task. From maintaining the aircraft and hangars to paying off highly experienced and qualified personnel, the costs are high. So far, the costs were covered well as the discretion to bill their services had no curbs. Now, with the new bill, the air ambulance companies will have to make do with what the insurance companies approve. Failing to agree on the pricing will only lead them to an arbitrator whose decision will be final.
What Can the Air Ambulance Industry do?
It goes without saying that profits will dwindle down. However, as most air ambulance companies have already begun doing, it makes sense to join insurance networks. This will ease the payment process. Also, it is time that the industry looks at quality services wherein patients voluntarily opt for their services, even if it means that they will need to pay an out-of-pocket premium. The air ambulance industry now needs to veer its attention towards brand building activities. In this context, it must be noted that the service providers are still not compelled to limit their bills. The only change is that patients will no longer be liable to pay balance bills unless they opt to do so.