Congress must act to ensure access to air medical services

Whitney Corby, a Division I lacrosse athlete for the University of Albany, was driving to the gym in Corning, N.Y., when she hit black ice and crashed into a tree. Whitney had broken bones, a fractured skull, and a traumatic brain injury. The crew who arrived at the scene knew they couldn’t treat Whitney and that she was running out of time. They called the closest air medical provider and drove Whitney to a nearby school football field, where the helicopter could land with the critical care team. She was transported to Robert Packer Hospital in Sayre, Pa., where she began her long recovery. Whitney’s doctors told her family that if she had not been flown by air ambulance, they would be telling a very different story today.

As members of Congress who represent rural communities, one of us a physician trained in emergency medicine and a former flight physician, we know firsthand from our constituents the importance of access to lifesaving emergency air medical services.

{mosads}When you are hundreds of miles from a hospital, every second counts, and air ambulances can make the difference between life and death. For example, if you suffer a stroke, the sooner you receive treatment after the onset of symptoms, the greater your chance of full recovery. According to the American Stroke Association, not arriving at a hospital in enough time is a key reason people miss brain-saving treatment and a better shot at a recovery that not only preserves a better quality of life for the patient, but also saves the high cost associated with long-term health care for severely debilitated stroke patients.  

Unfortunately, air medical services for Medicare patients are not reimbursed at the true cost of care; these reimbursement rates have not been updated in almost 20 years. Meanwhile, air medical costs are increasing, our population is aging, hospitals are closing, and the percentage of Medicare patients being transported by air ambulances is growing. In fact, the majority of transports – roughly 70 percent – are patients who are on Medicare, Medicaid or are uninsured. As a result, without a long overdue update to Medicare reimbursement rates, patients will lose access to these lifesaving services because more air ambulance bases will be forced to close and consumers will pay higher out-of-pocket costs.

The importance of these lifesaving services is why we introduced bipartisan legislation to help trauma patients get the helicopter transportation that will often save their lives. Our bill, the Ensuring Access to Air Ambulance Services Act, would be a major step toward finding a long-term solution to the Medicare reimbursement shortfall that can lead to air ambulance base closures and higher out-of-pocket costs for patients, reducing access to these critical services. The bill updates Medicare reimbursement rates for air ambulance service providers based on actual cost data. It would also establish a value-based purchasing program, which would collect quality of care data from providers and link higher payments to higher-quality scores.  

In the worst emergencies – not just stroke or heart attack, but highway car wrecks or urgent neonatal transports – first responders or attending physicians make the determination that the patient’s best chance of survival and recovery is to be transported by an air ambulance to an appropriate hospital where their medical needs can be addressed. 

Without a doubt, these air ambulance services play a critical role in emergency response. This is particularly true in rural areas like our districts in north central Indiana and Eastern Riverside County, Calif., where the closest trauma centers or emergency rooms are miles away and the fastest way to reach those facilities is by helicopter. 

That’s why groups like the American Nurses Association, the Consumer Health Coalition, Consumer Action, Mothers Against Drunk Driving, and the Association of Air Medical Services, among others, have joined us in urging Congress to address the Medicare reimbursement shortfall by passing this bipartisan, commonsense solution so that patients have access to the medically appropriate emergency response regardless of where they live or what kind of health care coverage they have.

Congress cannot wait to enact this critical piece of legislation. The stakes are simply too high.

Rep. Jackie Walorski represents the 2^nd District of Indiana and Rep. Raul Ruiz, M.D. represents the 36^th District of California.