Health Department offers plan to reduce air ambulance costs

SHERIDAN — The Wyoming Department of Health released its proposed plan to create affordable air ambulance services in Wyoming.

The proposed plan is trying to decrease the air ambulance cost and increase the availability of the service in Wyoming, said Franz Fuchs, policy coordinator and legislative liaison for the DOH.

Sheridan Memorial Hospital currently contracts its air ambulance services to Medical Air Rescue Company and has a helicopter base located in Sheridan.

According to DOH, the average flight costs a Wyoming employer is $36,000. Medicare would pay 59% of the cost in 2015.

Part of the high cost is that air ambulance providers are not in the same network as insurance companies of many providers, meaning the insurance provider will cover less of the cost.

MARC tries to work with insurance companies to become a provider with them, said Rylie Beckstead manager of MARC’s Sheridan base.

“We have seen across the board that MARC charges are about 45% less than the bigger companies currently serving in Wyoming,” said Jay Johnson, senior director of base operations for MARC.

According to the presentation by the DOH outlining their plan, 91% of air ambulance flights are interfacility flights— hospital to hospital— and the rest are emergency response flights in 2018. Air ambulance services for each county were also shown.

From this information, their proposed plan would determine how many bases are needed and where they would be located to provide the best coverage and response time in case of emergencies. These bases would be contracted out to an air ambulance company, letting the competitive bidding market bring the prices down, Fuchs said.

Most of the bases in the proposed plan were marked for helicopter bases. Wyoming is very rural with rough terrain and fixed wing air ambulances can only take off from airports. Helicopters have the ability to land or close to the site of emergencies, even in rougher terrain, Johnson said. 

WYDOH has not determined where the bases will be at yet or how many there will be.

A central call center for all of the bases would be used to dispatch the nearest air ambulance to the emergency site or to the hospital for transportation.

Fuchs said the plan should help each base be more efficient and increase the use of a single base. With the increase in use, the cost to run the base would be spread out over more services, allowing the price of the air ambulance to be spread out to more people. His hope is that this would allow the cost of an air ambulance to go down.

Johnson said he thought the plan was interesting, but did not know if it will work out for the state. MARC would be interested in placing a bid for the service but they would not be big enough to cover the whole state, only a region.

WYDOH is working on the plan and has more obstacles to overcome before it can be implemented. WYDOH staff is in discussions with Centers for Medicare and Medicaid Services. CMS is a federal entity and WYDOH would need to be partnered with them to prevent the plan from being shut down due to federal regulations, Fuchs said.

The 1978 Airline Deregulation Act prohibits states from regulating price, route or services an air carrier could provide. This has stopped other attempts made by states to regulate air ambulance services.

If WYDOH can receive approval from the federal level for their plan, they would still need to get state statutes changed and state legislation would need to approve the plan, Fuchs said.