— One moment, Cynthia Bowers was driving her quad through the forest south of Mormon Lake. The next, she was coming to consciousness…
MORMON LAKE, ARIZONA — Cynthia Bowers was charged $29,900 for air medical helicopter transport by Guardian Air Transport, which is under the umbrella of Northern Arizona Healthcare.
As reported by the Arizona Daily Sun, One moment, Cynthia Bowers was driving her quad through the forest south of Mormon Lake. The next, she was coming to consciousness after being thrown from the off-road vehicle and into a nearby boulder.
She had broken her arm and her elbow and she could feel a searing pain in her hip. She struggled to breathe and had numbness in her fingers and parts of her legs.
Soon, she was joined by her husband and two other couples who were in the area. Someone called 911 and then a helicopter arrived, landing in what Bowers said was just a tiny patch of grass in the forest.
Paramedics were worried she might have been bleeding internally or suffered injuries to her spine, so they didn’t want to risk driving her out the bumpy forest road via ambulance, Bowers said.
Instead, she was lifted into the helicopter and flown 25 miles to Flagstaff Medical Center.
Now, Bowers is on the path to recovery, but one thing still hangs over her head: the $29,900 bill for the helicopter ride, from Guardian Air Transport, which is under the umbrella of Northern Arizona Healthcare.
Newly retired, Bowers just became a member of a nonprofit health cost sharing ministry, which is an alternative to a health insurance plan, and hasn’t yet heard how much of the air ambulance cost that program will cover.
“I’m just holding my breath and praying,” she said.
While air ambulance bills routinely run into the tens of thousands of dollars, as recently as April, Bowers’ bill from Guardian Air would have been about 30 percent less. According to a state filing from April 18, Guardian Air would have charged about $21,000 for the same trip.
Between April 18 and June 6, when state data was next updated, Guardian Air’s base rates jumped an average of 48 percent and its per-mile rates jumped an average of 35 percent.
The company is not alone. A 2017 report from the Government Accountability Office found that between 2010 and 2014, the median price for helicopter air ambulance service doubled from $15,000 to $30,000 per ride. That’s according to federal Medicare data and private health insurance data.
In an email, Guardian Air Transport Program Director Dustin Windle said operations costs are high because of the training, staff and and equipment needed to respond to and transport a range of cases, from adults in critical condition to high risk pregnancies to neonatal patients.
While there are several air medical operators in the region, Guardian Air, which is a nonprofit company, is the only service that transports all patient types, Windle said.
The company flies about 3,000 transports per year across roughly the northern third of the state. It has eight aircrafts based at seven facilities.
The rate increase, Windle said, was needed.
The company was below the state average for air transport and the increase puts it closer to the middle of the pack, he said.
What it means for patients
The rise in rates affects those who have commercial insurance or who don’t have insurance. Those on commercial insurance make up less than 20 percent of the patients that Guardian Air transports, while more than 70 percent are on Medicare or Medicaid. All of those people aren’t charged for any remaining balance after reimbursement by those programs, Windle said.
Commercial insurers cover a range of the total service cost, from more than 80 percent to less than 30 percent, Windle said. He said Guardian Air will work with patients who don’t have insurance or whose insurance plans don’t cover the full cost of an air ambulance trip to establish a payment plan or other option.
System-wide, Northern Arizona Healthcare writes off approximately $100 million annually for services that patients aren’t able to cover, he said.
Reimbursement dropping
On a national level, the costs to patients have increased as the expense of running air ambulances has climbed, while reimbursement from the government-funded Medicare program has stayed stagnant, Blair Beggan, a spokeswoman with the trade group Association of Air Medical Services, told the Associated Press.
Windle said Guardian Air has seen reimbursement from out-of-network insurers drop while both Medicare and Medicaid pay significantly below cost. Arizona’s medicaid program, for example, offers a base rate reimbursement of between $1,100 and $2,500 — just a fraction of the $20,000 to $23,000 Guardian Air has set for its base rate costs. Beggan told the Associated Press that Medicare reimburses ambulance companies for about 58 cents on the dollar.
Recovery
Bowers eventually found out she had broken her humerus and her elbow, had torn her rib cartilage and had a hip pointer injury. Despite the hefty bill, she doesn’t regret getting airlifted to the hospital, Bowers said. In the state she was in, every little bump in an ambulance would have been painful, she said.
“It was a pretty bizarre thing; it was scary, very scary,” she said of the experience. “I’m very thankful to be here.”
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