Tuesday, May 10, 2016

Air ambulances may be called when they aren't needed to keep for-profit service from leaving markets: Low call volumes lead to regionalization

CITRUS SPRINGS, Fla. - In March, the I-Team and the ABC News Brian Ross Unit reported how Air Methods, the nation's largest air ambulance service, charges patients high rates for helicopter rides that aren't covered by most insurance policies.

A Citrus County family has now come forward, saying they believe that in their case an air ambulance was called when it wasn’t needed just so the service doesn't go away.

Air Methods flew 100,000 patients last year, or about one out of every four air ambulance transports in the United States.

“We serve 82 million rural Americans across the country who would not have access to trauma care within the critical hour or what's called ‘the golden hour,’” said Paul Webster, Air Methods vice president, told ABC News.

But Donna Nichols believes a flight that transported her husband may not have been necessary. 

Chris Nichols, a popular basketball coach at Lecanto High School, was an Air Methods patient six years ago.

“I got a call stating my husband was in a bicycling accident in Citrus Springs and that a helicopter was coming to get him,” said Donna Nichols.

Nichols hit a patch of gravel and fell off his bike.

When Donna reached the scene a half hour later, Chris was still there, alert and conscious.

“Putting him in an ambulance and taking him to Shands would have been 45 minutes,” Donna Nichols said. “So if you're dealing with this golden hour, the golden hour was there by ground travel. There was no reason to call in a helicopter."

It took the crew 98 minutes to get Chris to the hospital after flying in from another county. 

A company representative told Citrus County Commissioners a few months after Chris Nichols’ accident that that the local base was closed months earlier because there weren't enough calls.

Aeromed, which was operated as a partnership between Air Methods and Tampa General Hospital at the time, appeared before the commission to request a Certificate of Convenience and Necessity to continue to operate the air ambulance service in Citrus County.

“If we didn't negotiate a way to increase our volume and increase the need for the helicopter, then we were gonna have to close up and would not be around at all,” Aeromed Representative John Scott told commissioners.

Air Methods has closed other Florida bases to cut costs. 

“They have to have volume. They have to have a market in order to stay alive,” Scott said.

In 2013, TGH subsequently selected another helicopter provider for its Aeromed air ambulance service “due to concerns about the consistency in the services provided by Air Methods," it stated in a letter presented by TGH Aeromed to Polk County Fire Rescue.

A report says after air methods closed its Tallahassee base, average response times jumped from 20 to 35 minutes, and helicopters were often unavailable.  

“When there is a public company or company that has to make a profit at the end of the day, we get away from maybe the one or two flights for patients that really have those critical needs to then just having to fly people in order to service a certain area,” said Stephen Barbieri, Nichols’ attorney and a former member of his basketball team.

"Eighty percent of our costs are fixed. So whether we fly or not, we're incurring those costs. So when you ask what is the cost per transport? That all depends on how many transports there are, obviously,” said Webster.

Air Methods has also recently raised rates.

“Well, I think it's necessary to have doubled the price over the last five years,” Webster said, citing larger numbers of Medicare and Medicaid patients being transported.

Reimbursement rates for those cases are about $5,000 each.

Webster says the actual cost to transport each patient is around $10,500.

The company posted $108 million in profits last year, averaging nearly $1,100 per patient, based on 100,000 transports the company said it had last year.

Webster says Air Methods loses money on seven out of 10 patient transports.

The Nichols say they can't afford to put profits into investors' pockets.

Chris retired early from his job teaching and coaching at Lecanto High School due to multiple strokes and a dangerous infection unrelated to his bicycle accident.

Donna had to take time off work to care for him.

Air Methods originally wrote off the Nichols’ $11,000 bill, turning it over to collections.

In 2014, the company sued the Nichols for the balance, along with interest and legal costs.

“It's wrong that we have to worry about this,” said Chris Nichols.

On Tuesday, the Nichols agreed to settle their case with Air Methods for a smaller percentage of the amount the company says they still owe.

Barbieri and some of his former teammates at Lecanto High School hope to help the Nichols pay Air Methods the remainder of what they owe.

They hope to announce future fundraisers to help the family, but in the meantime, are accepting donations through the non-profit Citrus Youth Basketball organization.

You can access that organization's website at www.citrusyouthbasketball.com

Story and video:   http://www.abcactionnews.com

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