Out-of-pocket payments made by patients transported by Helicopter Emergency Medical Services (HEMS)

Abstract

Objective: Recent news media have reported that Helicopter Emergency Medical Service (HEMS) programs use the practice of balanced billing, resulting in exorbitant charges not covered by insurance companies and financially burdening patients. To date, no study has described the billing practices of HEMS programs. We look to provide transparent billing practices and average patient payment of one midwestern non-profit HEMS program and report the reimbursement data of both federal and private insurance policies for transports.

Methods: Collated billing data were obtained from a HEMS program for two time periods from January 2017 through June 2018 (P1) and July 2018 through December 2019 (P2). From P1 to P2 the base charge per transport was increased. All transports that generated a bill during the periods were included and descriptive statistics were used to depict the findings.

Results: Per flight, base charge was $19,158 in P1 and $33,023 in P2. On average, patients paid $158.09 and $178.99 out-of-pocket, respectively. Reimbursement practices of insurance companies varied widely across time periods and among each other.

Conclusion: The amount charged by this HEMS program and amount patients paid on average for flights was less than has been commonly reported in recent news media. More transparency in costs and payments between non-profit and for-profit HEMS agencies should occur.

Keywords: Cost; HEMS; Payments.