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Evolving how we manage air ambulance costs on behalf of our members

Key Takeaways

  • We chose to engage an air ambulance management service to best support our members’ care experience and lower their costs.
  • Our process for covering air ambulance services is similar to other insurers.
  • In most cases, the 2022 No Surprises Act will help protect our members from being balance-billed.
  • Emergency air transport between facilities is covered, with in-network benefits applied, in situations where a longer ground transport time would endanger a member’s life.

It’s no secret that air ambulance is one of the most expensive forms of transport – and its cost has continued to spiral at a rate far exceeding inflation.

What is less commonly known is that the majority of air ambulance rides, while urgent, do not constitute an emergency.

Most transfers are moving stable patients, who are seriously ill, from one healthcare facility to another. It’s estimated that more than half of air ambulance transports could be safely completed using ground transportation. Over the past several years, the companies who provide “a ride in the sky” for medical care have been highlighted by Consumer Reports, NPR, and others for their all-too-common practice of saddling patients with enormous bills following service.

BlueCross continues to advocate for quality care and lower costs on behalf of our members, including an evolution in how we cover air ambulance services which include:

  • rotary (helicopter) transport, typically used to transport patients shorter distances for emergency care, and
  • fixed-wing (airplane) transport, for patients traveling long distances for specialized care.

Here’s what you need to know about how we work with these providers.

Our history with air ambulance services

In 2022, BlueCross paid $62.3 million for members to receive air ambulance care, an increase of roughly 23% from 2016. By 2016, we were paying more than $50 million per year to cover air ambulance services for our members, a rapid rise in costs from previous years.

In 2017, we invited air ambulance providers to join our networks. We offered to pay more than what they receive from Medicare and encouraged them to follow our prior approval processes, which are designed to ensure that members receive the right level of care at the right time. These changes were designed to lower costs and ultimately save our members money.

While several providers did join our network, the vast majority of air ambulance providers opted not to lower their prices or change their business practices to do right by Tennesseans.

Over the past six years, the number of BlueCross members receiving air ambulance care has nearly doubled. Out-of-pocket costs for air ambulance services have continued to rise unsustainably, as these providers continue to pursue a money-making strategy at the expense of Tennesseans.

Taking a new approach to air ambulance coverage

These costs are still spiraling for our members and employer customers, and we knew we needed to take further action on their behalf. So in April, we established a new contract with an air ambulance management company, Alacura.

Alacura serves a number of insurers around the country and gives our members access to a network of 16 air medical services, with more being added. Their work helps our members get the right care at the right time while delivering significant savings that will ultimately result in lower premiums for our members.

We hope that these efforts, combined with the protections the 2022 No Surprises Act offers against balance billing practices, will provide peace of mind for BlueCross members receiving emergency medical transport and help BlueCross to manage the cost of coverage for those we serve.

We realize that in many cases, the members are caught in the middle of the payment process, and we are committed to doing everything we can to protect them from unfair charges.

About Marc Barclay, Senior Vice President, Provider Network Management

A photo of the authorMarc leads a team focused on strengthening our statewide provider networks, which ensure BlueCross members have affordable access to high-quality care.

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