posted December 14, 2023

Air medical transport has been facing challenges in recent years, with a few emerging trends currently at the forefront. We are seeing changes in the industry emerge, from staffing shortages and increased specialty transports, to feeling the effects of the No Surprises Act. As we approach the end of 2023, we want to share the top three trends that we have observed here at Air Methods. 

1. Staffing Shortages

The industry, including medical transportation and healthcare facilities, is being heavily impacted by staff shortages affecting roles such as pilots, healthcare workers, and maintenance technicians. The presence of skilled personnel is crucial for providing high-quality care. However, it’s not just the medical transportation industry that’s grappling with these challenges. Hospitals and health centers are also struggling to maintain adequate staffing levels. Many rural communities are facing the decision of closing beds or units due to insufficient staffing. In some cases, specialty services like Labor and Delivery are being cut back. These shortages are placing enormous pressure on local ground transport and air services to ensure patients receive the necessary level of care. 

Key insights into the reasons behind staff shortages: 

A critical factor behind the shortage of medical professionals in the air medical industry is the high demand for their services. As the population grows older and medical emergencies become more frequent, the need for skilled practitioners and pilots in air transportation is rising. Becoming a qualified medical professional in this field requires rigorous training and extensive financial investment, which can put off some individuals from pursuing careers in healthcare. Furthermore, the competitive job market for healthcare and aviation sectors makes it challenging for the air medical industry to attract and retain top talent. 
 
Meeting strict safety and regulatory requirements also presents challenges for professionals working in air medical transport. The aviation and healthcare industries are both highly regulated to ensure the safety of patients and crew. This demonstrates the need for constant training and certification in addition to experience, which adds even more pressure to an already high-stress environment. Workload and stress are other significant factors associated with the air medical shortage crisis. Air medical professionals frequently face demanding work schedules and high-stress situations, which can lead to burnout and affect employee retention rates. 
 
Overall, these challenges contribute to a shortage of medical professionals in the air medical industry, a crucial component in transporting critically ill or injured patients quickly and efficiently. 
 
Read more about pilot staffing shortages here. Read more about clinical staff shortages here. Read more about AMT staff shortages here. 

2. Increasing Demand for Specialty Transport

Specialized transport is on the rise, particularly in the fields of pediatrics and cardiovascular care. This includes transporting pediatric patients and newborns in the neonatal intensive care unit (NICU). We have also seen an increase in cardiovascular assist device transports for patients that require specialized interventions like IABP (intra-aortic balloon pump), Impella and ECMO (extracorporeal membrane oxygenation).  

Key insights into reasons for increase in specialty transport: 

The number of patients being transported by air has grown in recent years due to several factors. One of them is the regionalization of care as healthcare systems concentrate specialized services in specific hospitals. This often means that patients need to be transported from one facility to another, and air transport is crucial for ensuring they have access to these specialized centers. In addition, advances in neonatal and pediatric care have expanded the range of conditions that can be successfully treated in pediatric patients, making air transport an even more viable option for critically ill children. 

Another factor driving the increase in air medical transport for patients is the growing awareness and utilization of this service. Healthcare providers, emergency medical services, and the public are becoming more aware of the benefits of air medical transport. Increased awareness and utilization of air transport services can provide a critical link in the chain of care, helping ensure that patients receive the specialized care they need in a timely manner. 

Population growth is also contributing to the rise in air transport. With more and more people living in urban areas, traffic congestion on the ground is often a factor that can hinder the safe transport of critically ill patients. This increases the need for air transport, which can bypass ground traffic and quickly bring patients to the medical facility they need. 

Read more about the increase in pediatric specialty transport here. Read more about the increase in cardiovascular specialty transports here.  

3. The No Surprises Act’s Impact on Medical Transport  

The No Surprises Act went into effect in 2022 for the air medical industry. This is a law that Air Methods strongly supports as it removes patients from the middle of any billing dispute between medical providers and insurers, thereby protecting patients from “balance bills.” Now, when an out-of-network insurance company refuses to cover or under-reimburses for an emergency air transport of one of its customers, the air medical provider and insurer can enter an independent dispute resolution (IDR) process to resolve the billing dispute. This new system eliminates the possibility that a patient could receive a bill for unpaid transport. Unfortunately, the IDR process has been structured to favor insurance companies rather than air providers, particularly those in rural areas, and these remaining out of network health plans have pursued tactics of delaying payment or underpaying for critical services. While Air Methods has been a leader in the industry going in network and today is 76% percent in network with health plans, we have had to pursue the IDR process for the remaining out-of-network transports. We win these cases 87% of the time but it has delayed payments by months. States are looking at similar NSA-style initiatives for ground transportation, which may result in similar cost pressures for ground transport. We will have to wait and see if these changes result in loss of access to ground transport for patients leading to further demand on the air transport industry to fill the gap left by ground transportation, especially in rural America. 

Read more about the No Surprises Act and its impacts here.