Why should case managers use fixed-wing air ambulances?

I felt that the last blog entry was a little negative as I was trying to point out the excessive costs brokering has put on the air ambulance industry. This blog will be dedicated to more of a positive a productive note as to why you should use an air ambulance company for a long distance medical transport.

• Over the range of 200 miles, airplanes are much more economical than both ground and helicopter medical transports
• By having 2-3 air ambulances that are trustworthy, reliable, and reputable, an air ambulance provider can significantly decrease the overall workload of a case manager
  
• Depending on the patient’s medical condition, speed can be a necessity. You may not need a Citation X to get you across the country in 1 hour, but shaving a 12-hour road trip on a stretcher to 2 hours in an airplane can significantly help. How long would you like to be in the back of an ambulance?
  
• Helicopter transports are notoriously expensive, slow, and rough. The patient will have a much smoother ride in an airplane
  
• Major airlines do not have the medical setup for intensive care situations
  
• You are guaranteed professional trained medical personnel if you go with someone that has state accreditation
  
• It is one more resource that a case manager or social worker can have available to them
  

Why are fixed wing air ambulance transfers so expensive? Let me tell you how the patients are getting taken advantage of!

I am a firm believer that every individual has the inherent right to start a business, charge for a service, and make a profit. It is the backbone of our economy. The question to any entrepreneurial business is simple, what service will you provide? In the air ambulance business, service is divided into 2 main categories: 

1)   Air Ambulance Providers – The aircraft carrier that holds a Part 135 certificate, is certified by the health department in their respected state, and holds any other accreditations that somehow raises their own superiority and ego

2)  Brokers – Marketing agents that act as air ambulance providers, incorporate a referral fee into their quote, dump their profits back into marketing, and dry up the pocket books of the patients while sipping Mai Tai’s at their desk. In other words, brokers are liaisons between the providers and case managers and they incorporate thousands of dollars into their referral fee.

I was on a trip recently with a patient that we will call Jane. Jane was going home for hospice care to live out her last days with her family. As with any trip, 50% of the work in the back goes into talking with the family, making sure they are cool, calm, collected, and comfortable.  After a 2-hour trip, they started discussing the challenges of coming up with the money for the flight. They had maxed out their only credit card and then turned to their church for the remaining amount. This was something they needed to have accomplished ahead of time because most air ambulance flights are paid up-front.

I almost fell out of my chair when I saw the $17,000 check this needy family handed over. The trip had a come from a broker who made it sound like he was facilitator. Worst yet, he made the air ambulance provider sign a waiver stating they would represent themselves as the referring company (which I am not even sure is legal).

Guess what the air ambulance provider charged? $9,100. That means the broker, aka…that fat dude in a trailer park with a phone, just hosed Jane and her family out of $8,000. Will insurance cover it? NO!

The challenge of any air ambulance provider is how to compete in this type of environment. A true provider has airplane maintenance, staff, fuel, hangar, insurance, and a small amount of profit to incorporate into their trips. The broker has marketing, their phone bill, and Hawaiian shirts to charge for. So what happens? The providers then start brokering trips.

So all of the sudden, you have all these air ambulance providers referring (aka brokering) trips out to other providers, and brokers brokering trips. Now everyone is brokering everything – and then you have overly inflated charges that are making the entire family walk with a permanent limp. So there you are, expensive air ambulance trips.

So if there is a single case manager or family member reading this – Do your research and get as many quotes as possible! Do not look at the top ranked companies in the search results; they are most likely people with big marketing budgets, who most likely will not even do anything more than make a phone call.

How to spot a broker:

·      Say they have a hundred, if not thousands of airplanes in their fleet

·      If you type in your city and a company pops up saying ‘Tampa Air Ambulance’. Every broker has a listing in every city and will claim to be from that city.

·      If they say they have multiple locations. Most providers have 2 locations at best

·      The website has generic pictures with nothing specific to their individual airplane

·      They answer the phone ‘air ambulance’. Ya… no kidding, if I call Dell are they going to answer ‘computers’?

·      They do not know much about airplanes outside of them talking about ‘Cessna’s and Piper’s and Jet’s…oh my…’

·      If they have to get you on a conference call

·      They sound like a used car salesman

·      They are expensive