PITTSBURG, Kan. -- When most people think of air ambulance helicopters, they think of a major emergency where seconds count. But critics say that’s not the reality.
They contend that the majority of air ambulance flights may not even be necessary and are so expensive that they push some patients into financial ruin even though they have insurance.
George Sypniewski was shocked when he received a $47,000 bill from the air ambulance company that transported him from his local hospital in Pittsburg, Kansas, to University of Kansas Hospital in Kansas City, Kansas.
Sypniewski had been injured in a bicycle accident.
“I was high tailing it pretty good,” he recalled. “I hit some sycamore seeds. It lifted up my tire, and it was like on ice. I lost it.”
He immediately knew he was injured but didn’t know how bad until his wife drove him to the emergency room.
A doctor at Via Christi Hospital in Pittsburg told him he had broken his hip and crushed his pelvis and would need to go to KU Hospital -- 117 miles away.
"Two guys come around the corner: 'We'll take you.'"
Just like that, Sypniewski said, he became the latest victim of one of the most expensive and fastest growing parts of healthcare -- the air ambulance ride.
Critics say 80 percent of air ambulance rides aren’t emergencies. They're typically used to transport patients from a rural hospital with limited services to a hospital in a major metro center, something that used to be done by ground ambulances.
A typical air ambulance ride can cost $40,000, according to insurance experts. Even with good insurance, the average patient gets stuck paying at least half
of that tab out of pocket.
Here’s how it worked for Sypniewski. He was billed $47,000 by EagleMed for that one-hour ride. His insurance picked up about $26,000 of the bill -- far more than most insurance companies.
That left Sypniewski with a $21,000 tab. EagleMed wasted no time trying to collect, he said.
“Every two weeks (I’d get a call),” he said. "'What's going on? When are you going to pay?'"
A study by the Missouri Department of Insurance found air ambulance companies are aggressive in collecting payments, forcing some patients to mortgage their homes or even file bankruptcy.
Sypniewski called Oklahoma City attorney Ed White, who has sued multiple air ambulance companies for price gouging patients.
“At the worst possible time in your life, they are sending you these insane bills to pad the pockets of venture capitalist companies that are trying to extract just the maximum amount of money they can from people who have no choice but to enter into these deals,” White said.
White said there are more air ambulances than ever transporting patients even when a ground ambulance makes more sense, including in Sypniewski’s case.
“There are instances where this service is the only way to accomplish a lifesaving rescue, but going from Via Christi Hospital to KU is not one of those instances,” he said.
The air ambulance saved George about half an hour in travel time, but his surgery didn’t take place until three days later. If Sypniewski had been transported by ground, the cost would have been about $2,000 and would have been covered by his insurance, White said.
Each year the cost of air ambulances goes up about 10 percent, a rate that far exceeds most other healthcare costs, said David Powell, the owner of Benefit Management, Sypniewski's insurance company.
“Why does it cost $5,000 more for take off this year, than it did last year?” Powell asked.
He said Sypniewski’s bill was one of many ridiculous bills he’s received from air ambulance companies who won’t negotiate with insurance companies.
“We've seen helicopters called to Carthage, Mo., which is 12 miles away from a Joplin hospital,” Powell said. “By the time the helicopter got there and back, an hour and a half may have elapsed, whereas the ground ambulance is parked outside and could be there in 12 minutes.”
Air ambulance companies dispute the claim that any rides are unnecessary, saying it’s doctors who order them.
What doctors might not realize is that unlike most health care, the cost of an air ambulance ride is not regulated by anyone.
Air ambulances fall under the 1978 Airline Deregulation Act. The act was designed to make it cheaper for people to fly by letting the open market set prices. It worked. The price of airline tickets fell dramatically as customers started comparison shopping.
But you don’t have that luxury with air ambulances. Either you are too sick or there might be only one air ambulance serving your area. Many states, including Kansas, that have tried to regulate air ambulance rates have lost in court because of that federal law.
The only price controls over air ambulances are for people covered by Medicare and Medicaid. For example, an air ambulance ride that Medicare paid $4,500 for, would have cost $45,000 for someone with private insurance.
White said air ambulance companies have admitted on record that their actual costs are much lower than what they charge.
“Their own estimate is around $12,000; whereas they usually send bills for $40,000 to $60,000, even more,” White said.
Besides suing air ambulance companies, White said the only other way to fight back is to change federal law, exempting them from the Airline Deregulation Act.
Air ambulance companies insist they are not the bad guys and are providing a lifesaving service.
According to EagleMed, "The cost of being ready to deliver this complicated mix of safe aviation and the very best medical care requires a large investment in aircraft, pilots, medical professionals … and rigorous training regimes. We work very hard to keep costs down while providing superb patient care, 24 hours a day, seven days a week."