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The COVID-19 pandemic disrupted a lot of people’s lives, especially in healthcare. However, the impact on the industry’s supply chain was not something most people thought about. It happened fast, though. When nations began sending workers home and closed businesses to contain the COVID-19 outbreak, it caused an abrupt stop to many vital global supply chains. That impact was felt greatest on the healthcare industry, which was on the front line fighting the pandemic.
“It was kind of a shock to everybody, and it was felt with regards to PPE before anything else,” said Air Methods VP Supply Chain Jay Mahen.
The priority for healthcare providers was to ensure employees were safe and to provide them that crucial PPE. However, many quickly realized they did not have the supply levels necessary. Worse yet, usual suppliers were unable to provide the needed PPE or current allocations were not enough. Many hospitals had to ask employees to reuse what they could for as long as possible – often putting workers at risk of exposure.
It was crucial then to create relationships with new suppliers, and even ask employees for help. At Air Methods, the Supply Chain team put out a call to all teammates, asking if they knew of anyone providing PPE, or someone they had bought from the in the past, to help build a list of potential suppliers. They collated that information and began to build a portfolio of companies and do vendor evaluations. Many healthcare leaders did the same. According to a joint report from Becker’s Hospital Review and Cardinal Health, the pandemic caused the majority of supply chain and c-suite leaders to rethink supply chain partnerships and prompted them to work with new vendors or suppliers.
However, there were challenges using new suppliers and trusting that the materials provided were safe. This was especially important when some studies claimed that some products manufactured in India, Vietnam, and China were not technically certified to be used in a medical setting. So, the Air Methods Supply Chain team worked with the Safety department and enlisted local university researchers to help vet these suppliers and the products.
“We started sending some of these mask products to Colorado State University to be tested in their lab to see what the particle flowrate was – whether they met the filtering specifications required to be called an N95 mask. And the reality was they all did. So, regardless of what people thought, they actually did pass,” said Mahen.
While that problem seemed solved, there had also been reports that some masks had pinholes in them. So, the team had to adjust and be flexible once again. They hired workers to handle an additional quality evaluation and control of every item. Then, to ensure teammates that the materials they received were indeed safe, the Logistics team included all certification documents and results from the testing at Colorado State University with every package sent to the field.
Additionally, some larger, spread out healthcare systems, including Air Methods, found that they didn’t have systems in place to determine if they had the necessary PPE because departments had been ordering independently. So, they had to quickly create a centralized process.
For the Air Methods team, that meant having every air medical base return all their PPE to a single warehouse to be sorted and allocated internally. The team then created a mechanism offline, utilizing SmartSheets, to understand what was out there, who had it, how to access it, and then to redistribute where it was needed most. Once Air Methods had a good supply of trust-worthy masks and ensured a continuous supply, they were able to share with hospitals, solidifying and expanding on partnerships.
“If we identified hospitals that fell short – they didn’t have the PPE they needed, or they were reusing stuff over and over again – we were in a position of surplus, so we were able to provide PPE for our hospital system partners for a period of time,” explained Williams.
Air Methods sold the PPE at our cost to community EMS partners, fire departments, hospitals, and doctors offices that were in desperate need. Out teams also shared our supplier information with customers and pointed them in the direction of good suppliers that had reliable, high-quality material, after doing our own tests with Colorado State University.
Aside from the immediate shock of the PPE shortfall, there was also the question of what to do with existing vendors to ensure continuity of operations. Hospitals and healthcare systems could now be at risk if vendors were unable to provide materials due to shutdowns or quarantines. Once again, supply chain teams had to get creative.
For Air Methods, that meant working with existing connections and asking about discounts or rebates and adjusting payment terms (shifting to long-term pay to preserve cash) and ways to avoid escalation by taking on increases over a six-month period, for example. In some cases, this also meant spending money to protect the financial security down the road.
“It was wildly successful,” said Mahen. “The result was a million dollars in cash impact because of terms enhancements and then several million dollars in assistance in price reduction or escalation waits.”
After moving PPE ordering to a centralized process for oversight, supply chain teams faced yet another challenge: how to get it back to where it was needed most. This meant utilizing analytics and looking at patient numbers to see where the PPE was likely to be most needed.
The pandemic truly highlighted the importance of supply chains in an organization’s financial success, especially in healthcare, but it has also led to valuable improvement opportunities. The Air Methods Supply Chain team has been improving many processes with the learnings from the pandemic. For example, the previous decentralized model made it difficult to know what equipment and materials were at bases, and not knowing each bases’ vendors was impossible to manage, risky, and costly.
“We have identified a very focused need to centralize our clinical supply chain and build the infrastructure to support the new system,” said Mahen. “That’s a project we’re actively working now and hope to make significant progress by the end of the year.”
While the pandemic sent shockwaves across the world, particularly the global supply chain, the disruption has also served as a catalyst for opportunity. Our Supply Chain team learned how to act quickly and be flexible as challenges came their way. Additionally, it has helped create new relationships with vendors and suppliers we may not have otherwise embraced. It has also provided an opportunity to work with our hospitals and community partners in new ways. Most importantly, it has given the healthcare industry a chance to look at weaknesses in the global supply chain and find ways to improve and make create a more resilient system if – or when – the next pandemic hits.
The already-delicate rural healthcare system is severely off-kilter with no indication of returning to pre-COVID normalcy. For rural hospitals, which generally exist on thin margins even in the best of times, the situation has only grown more dire.
Just this year, at least 14 rural hospitals have closed in the U.S. This has incredibly adverse effects on population health and patient outcomes, as a 2019 study found that “death rates in the communities increase by nearly 6% after a rural hospital closes.” As we move towards recovery, it’s imperative that the 60 million people living in rural areas of the U.S. have timely access to care and that this care is adequately covered by payers.
Looking at ways we can restructure the healthcare landscape to be prepared for the next pandemic, air medical services have continued to make a difference for rural populations in several ways, including shortening time and distance to care, enabling safer transfers between trauma and specialty centers, and extending the capabilities of rural hospitals.
Shortening time and distance to care: Not only are rural hospitals disappearing, those that remain are often underfunded and understaffed, leaving them poorly equipped to treat certain patients. The lack of healthcare access due to geographic location is only exacerbated by this lack of capacity and resources.
In these scenarios, which are becoming more and more common, patients must be transported to more advanced facilities, such as trauma centers that are better equipped to treat their conditions. A major barrier to those facilities is distance: a ground ambulance may require hours of driving to reach the rural hospital, while an air ambulance may cover the same distance in under an hour.
Enabling safer transfer between trauma and specialty centers: Approximately 85 million Americans live more than an hour from a Level I or Level II trauma center if driven by a conventional ground ambulance. Without air medical transport service, these people, who represent 25% of the U.S. population, cannot access lifesaving trauma services in a timely manner.
Air ambulances are staffed with paramedics and nurses who can perform important care for trauma patients, which a rural hospital staff may not be familiar with delivering. Air medical service extends the reach of hospitals and specialty centers, preserving access to these lifesaving facilities for millions of Americans in rural areas.
Extending the capabilities of rural hospitals: Given the rapid closures and widespread vulnerabilities experienced by rural hospitals, air ambulances effectively serve as flying emergency rooms with lifesaving equipment and highly trained staff who treat patients in the air during critical moments helping rural hospitals improve outcomes.
Ensuring Adequate Coverage: Emergency air medical services are a low-volume yet integral component of the healthcare system, serving approximately one out of every 1,000 Americans annually. It is crucial that the healthcare industry remains focused on delivering access to care for the 60 million rural Americans. Rest assured that air medical services will continue to represent an essential lifeline for rural communities.
It’s been a strange, stressful year for our flight paramedics and nurses in eastern Idaho, with pandemic challenges adding a new burden to their ordinary tasks of patient transport and wilderness rescue. A job that once consisted of ferrying critical patients from outlying hospitals to larger facilities and stabilizing patients from trips deep in the backcountry and national parks in Idaho and Wyoming, is now strained by the complications of COVID-19.
For Air Idaho flight paramedic Kimber Dameron, new challenges arose for her and many other EMS workers: forming bonds with patients through dense suits that made them look like something out of a sci-fi movie; keeping whatever they’d need for a call outside their new protective suits; and following the pace of a year that felt impossible to get ahead of.
In rural America, small medical centers have seen an influx of patients due to the COVID-19 pandemic, and many patients have been turned away because there is simply not enough room. Planning during the past year for virtually anyone running health care systems in eastern Idaho was tough. At times for some rural hospitals, without ICU beds or the resources to care for COVID-19 patients whose health was rapidly declining, transferring patients to hospitals was an hour-by-hour affair.
Check out the recent coverage of the selfless work Air Idaho Rescue crews are doing eastern Idaho.
In rural America, small medical centers are seeing an influx of patients due to the COVID-19 pandemic, and many patients are being turned away because there is simply not enough room. In New Mexico, Air Methods air medical crews are answering the call to ensure patients can receive proper care.
Crews at Air Methods’ Native Air bases in New Mexico have been spreading the word about what it’s like transporting patients from rural areas to larger hospitals in major cities for treatment.
Members of the crew at Native Air’s Las Cruces base were recently featured in the Las Cruces Sun-News’ Healers and Builders series that recognizes citizens who heal, safeguard, and improve the greater Las Cruces area. The crew gave reporters a look at how they are tackling their new reality transporting COVID patients throughout the region.
In Carlsbad, Air Methods crews are transporting patients across state-lines to receive care due to staffing shortages. Since the pandemic, these crews are transporting more than 60 patients per month, which grew from 40 per month pre-pandemic.
Marnie Hill, an air ambulance pilot for Native Air’s Carlsbad base, said it best: “People are suffering. It’s our job to get them the best care possible. Sometimes the weather gets in the way, but we do the best we can for them. It’s our job. We put ourselves at risk. It’s as controlled a risk as we can make it.”
Check out recent coverage of the selfless work Air Methods’ Native Air crews are doing in Las Cruces and Carlsbad.
In this year of so many unprecedented challenges, we want to express our utmost appreciation for all the frontline heroes across the country who have sacrificed so much for others in the fight against COVID-19.
The air medical field was hit with many challenges, including uncertainty about the nature of the virus, questions about adequate access to PPE for clinicians, flight crews, and patients, and concerns about financial and job security. Through this, the pandemic revealed the resilience of Air Methods teams and their ability to pivot in the face of adversity to meet the needs of vulnerable patients needing treatment.
As we look ahead to the new year, we remain steadfast in our uncompromised dedication to providing care to people who need it most.
Here is a taste of some of the selfless work of Air Methods crews across the country during this tumultuous year.
As the number of COVID-19 cases continue to surge across the U.S., Nebraska doctors are seeing a dangerous milestone approaching – compromised quality healthcare. The pandemic has threatened the availability of hospital beds and, as healthcare workers explain, it continues to push them to physical and mental exhaustion. The irony though, as things get worse, they’re needed more, and that goes for all first responders, including a group often overlooked: flight paramedics.
In Nebraska, on any given day, a dream team of healthcare heroes from Air Methods could be called to transport a person in need of critical care via air ambulance.
Omaha-based WOWT 6 News got an inside look at the work Air Methods crews are doing throughout the pandemic to safely transport patients in the region. Air Methods is often called in by small hospitals who don’t have the specialized tools needed in emergencies – especially in rural areas that can be underserved from an advanced-care standpoint.
Check out the full story from WOWT 6 News here.
This past summer, Stephanie Queen joined the Air Methods executive team as the Senior Vice President of Clinical Services. With 20 years of nursing under her belt, Queen has leveraged her expertise and passion for improving the quality and safety of healthcare delivery across the country for Air Methods.
Before making the move to Colorado, Queen was at Riley Children’s Hospital in Indianapolis, where she served in the role of Director of Clinical Operations for PICU, CVICU, Burn ICU, ECMO, Cardiac Step Down, CVVH, and Cath Lab. Prior to Riley Children’s, Queen worked as a registered nurse in the pediatric and adult oncology spaces.
It was during her time at Vanderbilt University, where she received her Doctorate in Nursing Practice, that she first learned about Air Methods. Vanderbilt LifeFlight, a subsidiary of Air Methods, is a world-class leader in critical care, providing innovative air medical transport services for the Nashville, Tennessee region.
“The mission of Air Methods really resonates with me, which is what drew me to the company,” Queen explained. “Air Methods is the best of the best and our driver is to be better and focus on what we need to do to think differently.”
Since joining Air Methods, Queen has focused on revamping the leadership culture and the education structure into one that emphasizes clinician support and fosters an excitement to learn. Another focus of hers is clinician burnout – a topic that has been exacerbated by the COVID-19 pandemic. Being a clinician in the air medical field has its added stressors and Queen is committed to providing Air Methods clinicians with adequate PPE and training to ensure they can transport patients safely, effectively, and quickly. In recent weeks, Queen made the tough decision to turn clinician training virtual to minimize travel for in-person training labs.
“In the spirit of Thanksgiving this year, I am thankful for my family, my faith, and my incredible family here at Air Methods,” said Queen. “The work our teams do is admirable, and I don’t take lightly what a privilege it is to be making a difference in the lives of many across the country.”
Yesterday, the New York Times published an article about a COVID-19 patient in Pennsylvania who was transported by Air Methods. After the transport, the patient’s health insurance company, Independence Blue Cross, denied coverage for the COVID-related transport and medical care. The article incorrectly identified Conemaugh Medstar as the Air Methods partner that transported the patient, when in fact it was an air medical aircraft out of New Jersey.
We worked closely with the patient and her daughter throughout the claims process and provided the guidance that ultimately led to the claim being resolved. The patient’s daughter communicated with Air Methods and Independence while her mother recovered, but became concerned when Independence said they would not provide her with any information on the status of her mother’s claim. During that same time, Air Methods committed to working with both the patient and their insurance to get the claim resolved. We have set up a robust patient advocacy program to address such issues with insurers, as they happen often.
COVID-19 has hit healthcare providers particularly hard, including Air Methods. While many health insurers are reporting record profits during the pandemic, most health providers have been relying on CARES Act funds to make it through these difficult times, while continuing to serve every patient who needs us. As a recipient of CARES Act funding, Air Methods does not balance bill any COVID-19 patient and made that commitment even prior to receiving those funds.
It is also important to note that, despite our efforts, Independence Blue Cross has refused to go in-network with Air Methods, or any air medical service provider not affiliated with one of its partner hospitals. The company is an outlier in our negotiations with Blue Cross and Blue Shield plans, as we have had success going in-network with many of them throughout the U.S., including plans in Pennsylvania, Maryland, New York, and Virginia.
Complications like these could be avoided if Independence Blue Cross – along with the big three national health insurance companies: Aetna, CIGNA, and UnitedHealth – would negotiate in good faith with Air Methods and include us in their network of providers. But until they do so, insurance will continue to force their customers to go through their arduous appeals process.
The New York Times reporter reached out to Air Methods with a series of questions that we responded to in detail. Unfortunately, most of the information we sent her was not included in the article.
In the interest of transparency, we have decided to share the responses that we provided the reporter in full. We think this is important because it shows the level of detail that we shared and demonstrates Air Methods’ dedication to working directly with patients to resolve all billing issues.
The questions the reporter sent to Air Methods, and the responses we provided to her, are below:
1. Approximately how many coronavirus patients has Air Methods transported during the coronavirus pandemic? How many patients does Air Methods fly in a typical year?
Air Methods flies about 70,000 patients every year. Since the pandemic began, we have flown 3,300 suspected coronavirus patients.
2. Has Air Methods instituted any new billing policies related to coronavirus?
We publicly stated months ago, even before the CARES Act passed, that we created a special process for handling all COVID-19 patients and that we would not balance bill COVID-19 patients. Air Methods has remained committed to that practice.
3. How does Air Methods set the charges for inter-facility transport?
The cost of this around-the-clock readiness averages nearly $3 million per year for each air base. Further, approximately 85 percent of costs are fixed costs associated with operating an air base, giving companies little leeway in reducing costs on their own. And then, the payors set reimbursement rates for our services. We have no control over the number they settle on. We must appeal and/or negotiate the claim with the payor to receive a fair reimbursement. However, reimbursement for air medical services has not kept up with costs. Medicare, which covers air medical services in emergency cases only, established the current air medical service payment rates in 2002 based on an estimated 1998 cost pool. Today, the average Medicare per-transport reimbursement covers approximately half of the cost per transport, according to a cost study prepared for the Association of Air Medical Services (AAMS). Medicaid, on average, covers barely 30 percent. With the government insurance programs, Medicaid and Medicare significantly underpaying for transports, and uninsured patients paying very little (or nothing at all) for our services, any uncollected costs from those flights must be picked up by commercial payors.
4. Air Methods currently faces, by my count, six class action lawsuits in different states. Can you provide any comment on those lawsuits, which generally allege expensive fees and aggressive debt collection tactics?
While we cannot speak to the specifics of ongoing litigation, most of these lawsuits related to transports and associated billing are between six tp eight-years-old. Since that time, Air Methods has changed the way we do business, especially as it relates to the aftercare of our patients. For the past three years-plus, Air Methods has made it a priority to partner with insurers all over the country to develop in-network agreements that eliminate the possibility of a patient ever receiving a balance bill. We have seen a good deal of success and are now in-network with more than 50 insurers throughout the United States. We have also implemented a Patient Advocacy program through which we work directly with our patients’ insurance companies to coordinate reimbursements. This keeps patients out of the middle of the billing process, which can be confusing and stressful, especially while recovering from a serious medical issue. The average patient out-of-pocket cost for our patients is $167, which includes co-pays/deductibles. While Air Methods is in-network with nearly 50 percent of our commercially insured transports, it is our goal to be in-network with 100 percent. We have contracted with almost every payor in the markets we serve but have been unable to get Aetna, Cigna, or United to contract with us despite offering them lower rates which means their members remain stuck in the middle. In an effort to remove the patient, we are proactively contacting and signing agreements directly with employers who have health insurance coverage with Aetna, Cigna, or United to ensure that their employees have coverage for emergency air medical services.
5. Approximately how often does Air Methods pursue debt in court? Does Air Methods use garnishments and liens to collect debt? I came across one case where Air Methods pursued a $53k garnishment from a patient’s bank account and wanted to know whether that type of debt collection is common or uncommon for the company.
We do not use liens or garnishments to collect debt. There was, unfortunately, a time when Air Methods pursued debt through garnishments and liens. But that approach has been eliminated from Air Methods’ processes when pursuing reimbursement from health insurance companies. It is clearly an ineffective way to settle billing issues and we have no desire to put our patients through that stress after we have transported and treated them.
There are only two reasons we will refer a patient’s account to a third party billing agency. If a health insurance company directly provides the payment to the patient rather than us, the medical provider, and the patient doesn’t use such payment to pay for medical services rendered. Unfortunately, many times insurers tell their customers to hold onto the payment. The only other instance that would cause us to send a patient to a third party billing agency is if, after a number of attempts and at least 120 days, the patient is non-responsive to our calls/communications asking for insurance status after the flight, which allows us to assist them with their health insurance company to get their bill resolved. We assist patients by assigning a Patient Advocate to every individual we have transported whose insurance will not pay their bill. Patient Advocates work with patients after they have been transported to help guide them through the billing process and advocate on their behalf when insurance companies that are not in-network deny a claim.
6. In this story, I am looking at a $52,511 bill received by a patient who was inter-facility transported due to her coronavirus worsening. The patient was transported by Conemaugh Medstar, one of Air Methods’ subsidiaries. I attached that bill to a previous email for your review. Would you like to provide any comment on this case in particular, how the charges were set, and how the decision to bill [the patient] was made?
To be clear: We never sent a bill to [the patient], and our Patient Advocacy team assisted her through the entire insurance reimbursement process, which can be very confusing for our patients and their families. The outreach you referenced was the second communication from us to [the patient and was an update on where things stood with [the patient]’s insurance company, Independence Blue Cross Pennsylvania.
We have worked closely with [the patient]’s daughter since [the patient] is still in the hospital. She was incredibly helpful as her mother recovered and she did all she could to keep us updated on where things stood with their health insurance company. Independence Blue Cross initially provided a check that covered a small portion of the transport costs. Then, on June 24, [the patient]’s daughter reached out to tell us Independence was “not cooperating” with her family and that the reps from Independence would no longer discuss [the patient]’s case with her daughter nor with [the patient]’s husband either, who is the policy holder.
We told [the patient]’s daughter that we would assist the family with the underpayment appeal with Independence Blue Cross. We explained we would work with her and her family every step of the way, as [the patient continued to recover in the hospital. However, that same day, [the patient]’s daughter responded and told us Independence had informed her the initial reimbursement check was voided, and that the Independence rep would not share any additional information with her. We then reached out to Independence and a rep informed us that the claim had been denied because [the patient]’s plan “does not provide coverage for this service.”
After we learned that Independence had denied the claim, we reached back out to [the patient]’s daughter informing her that we would work with her on the appeal regarding this unfortunate denial of service. About a week later, [the patient]’s daughter told us she had spoken to an Independence rep, who told her the claim had been reevaluated and that a check would be sent to cover the entire cost of the emergency air medical transport provided by Air Methods. On August 11, we received an email from [the patient]’s daughter stating she had received a check from Independence for the full reimbursement, and she planned to mail it to us.
The above process illustrates that we do not bill patients whose claims have been denied by their health insurance plans. It is truly unconscionable that, in this case, [the patient, a COVID-19 patient, has her insurance company issue payment for only a small amount, then the insurance company pulls it back and voids the payment by denying the services, then it reevaluates the care and, finally, pays the for the entire cost of care that Air Methods provided. This all could have been avoided if they would have done their due diligence in understanding that the patient had COVID-19 and/or they would go in network with air medical services. For our part, our Patient Advocate teams work closely with our patients to ensure they have guidance through the reimbursement process. We do this so that they are not alone in figuring out the steps that need to be taken. [the patient]’s family was incredibly cooperative throughout the entire process, and we are grateful [the patients recovering and that we were able to assist her in resolving this claim.
7. Has Air Methods or any of its subsidiaries received any funding from the Provider Relief Fund in the CARES Act? If so, how much?
Air Methods has received funding from the Provider Relief Fund in the CARES Act.
Follow-up question from reporter: I’m a little confused though by the statement that you never sent [the patient] a bill. The document dated June 1 has a box that says “amount due” and offers various methods of payment, a website to pay at, etc. Why shouldn’t that be considered a bill?
The response is a bit long, but that is because this process becomes complicated when payors deny a claim for Air Methods’ emergency air medical transports – even when the transport is for a patient with complications due to COVID-19. Air Methods’ Patient Advocacy program is in place just for these situations – we are committed to walking our patients through this process and making sure they understand the steps being taken to resolve the claim so that they can focus on their recovery.
There are several reasons why the letter referenced in the story isn’t a bill. If the letter was the only correspondence the patient received, without any further guidance or explanation, we certainly acknowledge that it would be confusing. However, it was only one communication among many, over many months.
The letter referenced in the story was actually the second one Air Methods sent [the patient, and both of them explained that we were asking for her assistance in resolving the claim with her insurance company. We had already been in communication with [the patient]’s daughter where she advised us that they were expecting a reimbursement check from [the patient]’s insurance company, Independence Blue Cross Pennsylvania, prior to the letter dated June 1 was sent with that context in mind as [the patient]’s daughter planned to send that check to us as we worked with Independence to secure the remainder of the reimbursement. However, Independence then abruptly voided the check and told [the patient]’s daughter they would not share any additional information with her about the claim. [the patient]’s daughter then reached out to us and said Independence was “not cooperating” with her family and that the reps would no longer discuss [the patient]’s case with her or [the patient]’s husband, who is the policy holder.
This was all occurring as [the patient] was still recovering in the hospital. The letter we sent dated June 1 was sent after one of our patient advocates had already established communication with [the patient]’s daughter and explained how we would help her through the billing process with Independence. However, after the June 1 letter was sent, we then spoke with [the patient]’s husband on June 3 and he advised he was calling Independence to get the status of the reimbursement. Later that same day, [the patient]’s daughter called us and let us know she had spoken with the payor and had been told the claim was still in process. All of this background is to say, we are committed to communicating with our patients throughout the post-transport insurance process, and our goal is to ensure they have a clear understanding of that process. We spoke with [the patient]’s daughter several times throughout the summer. At no time did we give her the impression, nor do we believe she had the impression that we were pursuing payment from [the patient]). We were seeking payment from Independence Blue Cross Pennsylvania. If it were up to us [the patient] and her family would never have had to go through this process, which is established by the Independence Blue Cross Pennsylvania. The fact that she did is very unfortunate and Air Methods and our Patient Advocates do all we can to make it as easy as possible by working with the insurance company directly so patients like [the patient] and her family don’t have to.
Without the context of the many productive conversations we had with the [the patient]’s family, we acknowledge this one piece of communication (the letter) could be misconstrued as a bill. But it is not a bill and we believe [the patient]’s family fully understood that because we were in regular communication with them. What’s more, the goal of Air Methods is to go in-network with 100 percent of the health insurers in the U.S. to avoid these long, drawn-out situations that ultimately result in Air Methods receiving payment from the health insurance company anyway. It raises an obvious question: Why go through this long, drawn-out process in the first place? If payers – like Independence Blue Cross Pennsylvania, as well as the large health insurance companies like Aetna, Cigna, and UnitedHealthcare – would simply come to the table and negotiate with us, patients like [the patient] would not have to go through what she went through. For now, because this is the process dictated wholly by the health insurance companies that control whether these transports are covered, we do all we can to guide our patients through it. Obviously it’s a very complex situation, and one letter among months of communication certainly cannot tell the full story in any meaningful way.
As the battle against COVID-19 rages on, so does the demand for patient care in rural areas. Recently, Univision, a leading Hispanic media company in the U.S., got an inside look at the heroic work Mercy Air crews are doing during the pandemic to move patients out of crowded hospitals in Southern California. Mercy Air, a subsidiary of Air Methods, established a base in Imperial County to focus on serving residents and bridging the distance between patients and the level of care they require.
Imperial County, a rural and impoverished region in Southern California with a population of about 180,000 people, has been a COVID-19 hotspot. At one point, the county was averaging about 900 infections per 100,000 people, compared with 371 in Los Angeles County during the same two-week period.
In response to the surge in Imperial County, a Mercy Air team that primarily focused on car accidents and other emergencies near the border pivoted their efforts to transport COVID-19 patients to hospitals across the state. Since March, Mercy Air has taken more than 100 COVID-19 patients out of Imperial County for treatment.
You can watch the full story from Univision here.
Mercy Air’s work in Imperial County is one of many instances of Air Methods crews going out of their way to support vulnerable communities. Across the country, Air Methods teams have worked tirelessly to transport COVID-19 patients out of overcrowded rural hospitals to other facilities. We could not be prouder of the entire Air Methods team for their dedication to coordinating care on the frontlines for those who need it most.
Not long ago we joined our partner, Central Logic, a leading provider of innovative transfer center and on-call scheduling technology, to present a webinar on lessons we have learned since COVID-19 began to dominate our lives and the work we do.
Both Air Methods and Central Logic have enacted efforts during the pandemic that have the potential to change procedures long accepted in the healthcare industry. Hospital systems all over the country have been overwhelmed at one point or another as COVID spreads from urban centers to rural towns and regions.
Synergy and “coopetition” have been integral in the response to overwhelming adversity. From treating critically ill patients to protecting healthcare workers exposed to the virus to maintaining a steady supply of PPE – agility, clear communication, and focused decision-making have been the keys to weathering the storm COVID has brought to our healthcare system.
The lessons we have learned – such as coordinating mass transport of critical patients and quickly creating a regional access center from scratch – can be adopted by other health systems and public health entities to ensure patients are taken care of appropriately and safely. Should a second wave of COVID hit the country, we must apply these lessons. And this approach goes beyond COVID. What we have learned can also be applied to other infectious diseases; emergencies like largescale fires; natural disasters, and many other crises.
While it’s true that we have been dealing with infectious disease throughout history – from the mild to the highly virulent – management of COVID patients has changed the landscape of healthcare in various ways.
For Air Methods, the protection of air medical crews has never been so extensive and important. Once a transport is complete, crews must change out of their flight suits and shower, then decontaminate the aircraft before returning to base. Following up with hospitals to confirm which patients had COVID and determining whether crew members need to be proactively quarantined have also become common practice. The pandemic has required crews to take great care and deliberate steps while they quickly transport critical patients who are often on a ventilator and receiving complex prehospital care.
At Central Logic, highly organized and efficient communication amid a chaotic situation has been sharpened. The pandemic has underscored the importance of a clinician-staffed access center to ensure patients can be navigated to the right care as quickly as possible. They drive knowledge to identify high-risk factors as they occur, ensure all data elements are captured for care and determine what EMS personnel and hospitals should prepare for. A scripted approach is key to keeping care as streamlined as possible.
A variety of new best practices and processes have emerged from our battle with COVID. In situations like these, knowledge sharing between organizations is key. If we can gather up the lessons learned across the healthcare industry, we will be better equipped and more prepared for the next crisis.
Helicopter emergency medical services (HEMS) continue providing life-saving patient care while adapting to the volatile climate of the pandemic.
In a recent article, Always There, Always Ready, from RotorHub Magazine’s June/July 2020 Issue, Air Methods VP of Flight Operations, Jason Quisling, reflected on his experiences since the pandemic struck. While Quisling noted a decline in the number of scene calls (such as automobile accidents) since the pandemic, he also noted an increase in interfacility transports, including many confirmed or suspected COVID-19 patients.
Since the start of the pandemic, Air Methods has transported over 1,000 confirmed or suspected COVID-19 patients. These transports add complexity to a typical transport in that they require challenging coordination and precaution throughout the healthcare system to move patients for treatment. In his career, Jason said he could only compare today’s climate in the emergency air transport space to that of the 9/11 terrorist attacks – though far less complex, as the COVID-19 pandemic is more widespread and evolving.
This rapidly changing landscape has brought forth higher demands for new protocols to ensure safety, while maintaining a high quality of care coordination. Fortunately, the HEMS platforms have evolved in recent years. For instance, Air Methods crews have always carried contact, droplet, and airborne precaution PPE in the aircraft for viral infections, but it was rare that such equipment was ever deployed pre-COVID. Already on-board PPE, increased patient data and access to state-of-the-art equipment are a few protocols Air Methods now has in place that make implementing additional changes due to the pandemic a more fluid process.
As the world continues to be rocked by the unprecedented circumstances of the COVID-19 pandemic, first responders across the country work tirelessly to coordinate care for people who need it most.
Imperial County, a rural and impoverished region in Southern California with a population of about 180,000 people, has been a hotspot for COVID-19. The county has averaged 900 infections per 100,000 people in the last two weeks, compared with 371 in Los Angeles County. Imperial County also has the highest mortality rate in the state, averaging 28 deaths per 100,000 people. The rate in Los Angeles County is just over five deaths per 100,000 people; in California as a whole, the number is about 19 per 100,000.
Because of the high numbers in Imperial County, local hospitals have been overwhelmed with incredibly sick patients. A lack of space and staff has meant many patients have required transport to hospitals outside the county that have available beds and clinicians. Mercy Air, a subsidiary of Air Methods, established a base in Imperial County to focus on serving residents and bridging the distance between patients and level of care needed. A team that primarily responds to car accidents and other emergencies near the border pivoted their focus to transport COVID-19 patients to hospitals all over the state. Since March, Mercy Air has taken more than 100 COVID-19 patients out of Imperial County for treatment.
Mercy Air in the News
Mercy Air’s dedication to helping the people of Imperial County has not gone unnoticed. In recent weeks, the Los Angeles Times, Imperial Valley Press, and Univision have featured the air medical team doing their part to provide care to COVID-19 patients. We are incredibly proud of the dedicated team at Mercy Air, as we are of our crews all over the country that are working hard to support their communities during this unprecedented healthcare crisis