Princess Health and Air ambulances save lives in rural Kentucky, but are costly; Junction City buys Air Evac memberships for everyone in town. Princessiccia

Princess Health and Air ambulances save lives in rural Kentucky, but are costly; Junction City buys Air Evac memberships for everyone in town. Princessiccia

emergency medical service health care cost health insurance

Gusty 12:49 Add Comment

Medical helicopters are especially important to rural Kentucky because they get people to the medical care they need quickly, but this service comes at a cost that many can't afford, Miranda Combs reports for WKYT.

Air Evac Program Director Donald Hare told WKYT that "the average cost of a flight is around $32,000 and insurance pays, on average, $8,000 and $12,000 of that cost," Combs writes.

"About 14 to 16 percent of our flights are people with no insurance whatsoever and don't have the ability to pay for that flight," Hare said, noting that they try to work with people to set up a payment plan in this situation.

Jim Douglas, the mayor of Junction City, told Combs that his city council has decided to buy memberships with Air Evac Lifeteam, which has a hub in the Danville Airport, for everyone in the city to cover them if they need to use the service. He said more than 60 people were flown out of Boyle County on a medical helicopter last year.

"It could be a lifesaving thing," Douglas told Combs, and said it will "cost the city just under $12,000," Combs writes. And while he said he fully expected some people to use the service for non-emergency reasons, he asked,  "But who's to make the call? I wouldn't want to."

Michael Bentley, a paramedic, assured WKYT that most of their transfers are emergencies.

"We generally get called out to the sickest of the sick patients. We're generally not going out to 'Joe that stubbed his toe on the refrigerator at home.' Our patients are major trauma type patients or cardiac events that have happened to these patients," Bentley told WKYT.

Adam Tubbs, an EMT in Nicholas County, told Combs that medical flights were important because it takes "precious time by ground to get to an emergency call" in such a large rural county. He noted that, on average, they call for air ambulances several times a week. The Nicholas County Hospital closed more than one year ago.

The cost of these air transports has become such a problem that Rep. Tom McKee, D-Cynthiana, filed a bill during the last legislative session calling for a study of air-ambulance charges. The bill passed out of the House, but did not make it out of committee in the Senate.

Princess Health and Patients may be liable for big bills from air ambulances; state House panel approves bill calling for study of companies' charges. Princessiccia

Princess Health and Patients may be liable for big bills from air ambulances; state House panel approves bill calling for study of companies' charges. Princessiccia

air ambulances emergency medical service General Assembly health insurance legislature

Gusty 21:52 Add Comment

Air ambulance services have enabled rural Kentuckians to get advanced emergency care more quickly, but there's a catch.

"Increasingly, the service also can mean the difference between getting well at a price you can afford or at a price that could push you over a financial cliff," Trudy Lieberman writes for Rural Health News Service. "Air ambulances have become the centerpiece of a nationwide dispute over balance billing, a practice that requires unsuspecting families, even those with good insurance, to pay a large part of the bill."

On Wednesday, March 16, the state House Banking and Insurance Committee approved a bill calling for a study of air-ambulance charges. House Bill 273 was sponsored by Rep. Tom McKee, D-Cynthiana, "after a constituent of McKee�s was transported to the hospital via air ambulance after a fall, but it was an unexpected bill for thousands of dollars not covered by insurance which really knocked him off his feet," Don Weber reports for cn|2's "Pure Politics."

Rep. Tom McKee

"McKee says having more information about emergency care transportation may have allowed the individual to avoid the high cost," Weber reports, quoting him: �I have learned in looking at it that certain air-ambulance companies provide a subscription service for perhaps as little as $50 a year, that you can have coverage to know if you need to be transported, the full cost would be paid. As we move forward, I think we�re going to learn a lot more to at least inform people.�

McKee said the charges, which can run well into five figures, may seem huge �but those air-ambulance companies have to keep people on duty and have to have a full crew ready to go at a moment�s notice. But, I think as citizens, we all need to know where we are in regard to being transported and things like we�ve learned, a subscription service could be available.�

Some committee members said they want to see if the charges are justified. �It�s nice to know what the cost is, $40,000, but if it only costs them $8,000 to do it,� said Rep. Steve Riggs, D-Louisville. �So we have to learn more than just what the average retail cost is, we have to also learn more about what the profit margin is.�

Lieberman reports that your air-ambulance bill may not be covered "because the provider is not in your insurer�s network," but "Sometimes it�s impossible to tell if a provider belongs to a network or not. When you are wheeled into the operating room, are you going to ask the anesthesiologist if he or she belongs to the hospital�s network? How many accident victims suffering from trauma are going to direct EMS workers to check if the air service is in or out of network before they�re lifted to a hospital? You can also get stuck even if the ambulance company is in the network. An insurance payment may not come close to covering the cost.

�Rates ambulance companies charge private patients are much more than they are charging to Medicare or Medicaid,� whose rates are too low to suit the companies. Consumers Union Programs Director Chuck Bell told Lieberman. �The air ambulance industry has grown rapidly, and prices have shot up a lot with some companies trying to make a quick buck.�

Princess Health andBaby is born on Interstate 65 in Louisville during traffic blockage for President Obama's motorcade; father, nurse tell story.Princessiccia

Princess Health andBaby is born on Interstate 65 in Louisville during traffic blockage for President Obama's motorcade; father, nurse tell story.Princessiccia

babies emergency medical service

Gusty 13:29 Add Comment

Nurse and EMT worker and baby
Photo from Floyd Memorial
Hospital Facebook page

A baby boy was born along Interstate 65 April 2 in Louisville because the road was closed for President Barack Obama's motorcade and they couldn't get to the hospital.

Because he stayed in Washington to announce the nuclear deal with Iran, Obama was three hours late, putting him in Louisville right at the beginning of rush hour and causing a traffic nightmare.

MetroSafe told WAVE-TV it received a call at 5:25 p.m. saying a woman was in labor on I-65. And just before 6 p.m., the baby, an 8-pound, 9-ounce boy, Arley Keith Satterly, son of Jessica Brown and Zakk Satterley was born, WHAS reports. �We couldn't get nowhere, so I called 911,� Satterly said.

After Brown and Satterly realized that the baby was coming and they were in "traffic gridlock," Satterly began to ask the cars around them for help, Shalanna Taylor reports for WLKY-TV. �I started asking people in different cars if they knew anything about having a baby,� Satterly said.

One of them was a nurse, Tonia Vetter, Gill Corsey reports for WDRB-TV. "I told the dad, I said, 'I'm a high-risk nursery nurse at Floyd Memorial'," the hospital in New Albany, Ind., Vetter said. "It actually happened very, very quickly. ... I think she pushed one time and the head delivered, and then she pushed again and the baby was born." Other drivers provided a shoestring for the umbilical cord and a blanket to keep the baby warm, Corsey reports.

"I've attended a lot of deliveries, but I've never delivered a baby on my own, and I've certainly never delivered one in the middle of an interstate," Vetter said. "God was definitely watching over me, the baby, the mom, because she could have hemorrhaged. The baby could of had a cord or a shoulder or any number of complications could've happened."

An ambulance took Brown and Arley to the University of Louisville Hospital, where a spokesperson said the mom and baby were doing just fine and were in good condition.

Princess Health and Princess Health andPsychiatric patients' demand for emergency-room care presents a problem the Affordable Care Act won't solve.Princessiccia

Princess Health and Princess Health andPsychiatric patients' demand for emergency-room care presents a problem the Affordable Care Act won't solve.Princessiccia

emergency medical service emergency rooms hospitals Medicaid mental health Patient Protection and Affordable Care Act psychiatrists psychiatry

Gusty 11:23 Add Comment

Psychiatric patients' demand for emergency-room care has been a concern in hospitals, and it's going to get worse. Even though ERs are not properly equipped to help psychiatric patients, people still often go there with psychiatric concerns. Most ERs simply lack room to deal with such situations. According to a survey, 84 percent of emergency physicians say they have psychiatric patients "boarded" in their emergency departments awaiting transfer to a mental-health facility, Adrianna McIntyre writes for Vox.

"People having a mental-health crisis seek care in emergency departments because other parts of the health care system have failed them," said Alex Rosenau, president of the American College of Emergency Physicians.

A psychiatric patient who shows up to the emergency room may require immediate care at the hospital, and sometimes there isn't an open bed in the right department. Those shortages often necessitate psychiatric patients to wait in the emergency room, or board, until space elsewhere opens for them. Both the closure of psychiatric facilities and diminished state funding have contributed to the issue. "Between 1955 and 1997, total state spending on mental health fell 30 percent, a period during which most health spending grew rapidly," McIntyre writes.

If hospitals don't figure out how to deal with the problem, it's going to get worse. In fact, experts say the implementation of the Patient Protection and Affordable Care Act will only exacerbate the problem. Some studies reveal that insured patients are more inclined to go to the emergency room�even for non-urgent issues�because the cost usually isn't as high. Lower-income people are even more likely to do that, and this population will comprise many of the newly insured citizens.

Though hospitals want people to use the health system properly, they also want to make sure patients do visit the ER when it really is necessary. "We don't want to impose any barriers on people going to the emergency room," said Hans House, a clinical professor at the Iowa University Carver College of Medicine. "We don't want people to be afraid to go to the ER."

The Affordable Care Act has provided more funding for reimbursement of emergency psychiatric care in Medicaid, a service the public program doesn't generally cover. However, this doesn't address the lack of space in emergency departments. "We know that a lack of psychiatrists available and staffing patient beds is a barrier," House said. "That's a personnel issue." (Read more)