How it started: Brookings – High air ambulance charges concentrated in private equity-owned carriers (October 13, 2020)

  • “…rapid growth in air ambulance prices is borne by consumers both through higher insurance premiums and more directly through cost-sharing and surprise bills from out-of-network carriers. A recent study estimates that 40% of helicopter air ambulance rides result in a potential surprise bill averaging roughly $20,000.”
  • “…We find that helicopter air ambulance carriers owned by two private equity firms, who together make up 64% of the Medicare market, had a standardized average charge of $48,250 (7.2 times what Medicare would have paid). This is markedly higher than the $28,800 (4.3 times what Medicare would have paid) standardized average charge for the same service by air ambulance carriers that are not part of a private equity-owned or publicly-traded company.”
  • “A similar phenomenon is also apparent in the fixed wing air ambulance market. Air ambulance carriers owned by the same two private equity firms, plus one additional small private equity-owned carrier, represent 62% of the Medicare market and had a standardized average charge of $58,750 (8.7 times Medicare prices), while other carriers charged an average of $38,200 (5.6 times Medicare prices).”

How it ended: New York Times – A $52,112 Helicopter Ride: Coronavirus Patients Battle Surprise Medical Bills (October 13, 2020)

  • “An intubated coronavirus patient was declining rapidly when doctors decided to airlift her to a hospital with better critical care resources. ‘It’s life or death,’ the family of the 60-year-old woman recalled being told when it happened in April. ‘We have to transfer her now.’ The patient was flown by helicopter from one Philadelphia hospital to another 20 miles away. She spent six weeks at the new hospital and survived. When she came home, a letter arrived: The air ambulance company said she owed $52,112 for the trip.”
  • “The Pennsylvania patient had no way of knowing that her helicopter, which transported her between two in-network hospitals, did not have a contract with her health insurance plan. Nor could she have known that the air ambulance service, owned by a private-equity firm, faces multiple lawsuits over its billing tactics.”
  • “Last year, Congress abandoned its attempt to prevent surprise bills like this one, and coronavirus patients are now paying the price. Bills submitted to The New York Times show that patients often face surprise charges from out-of-network doctors, ambulances and medical laboratories they did not pick or even realize were involved in their care.”
  • “The plan to ban these kinds of bills was popular and bipartisan, and it was backed by the White House. It fell apart at the 11th hour after private-equity firms, which own many of the medical providers that deliver surprise bills, poured millions into advertisements opposing the plan. Committee chairs squabbled over jurisdictional issues and postponed the issue. Then the pandemic struck.”