Air ambulances could improve access to care in rural areas, but high costs pose a major barrier

Many Americans struggle with access to care—especially as rural hospitals close their doors for good across the country—but air ambulances have emerged as a potential solution to the problem. 

However, the cost of emergency air medical services is a major barrier to expanding these programs to more people in rural areas, wrote Suzanne Harrison, M.D., president of the American Medical Women's Association, and Kim Templeton, M.D., past president of AMWA, in a column for RealClear Health. 

A quarter of Americans—about 85 million people—are unable to access healthcare in less than an hour of travel time without an air ambulance, the pair wrote. Access to doctors varies widely across the country, particularly in light of the ongoing physician shortage

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Reimbursement rates set by Medicare and Medicaid, along with a number of private payers, for such services often cover a mere fraction of the cost of air ambulances, according to the column. The majority of people with a need for these services, about 70%, are covered by an insurer that will pay very little of the tab, or they lack insurance at all. 

A bipartisan bill introduced in the House last summer seeks to improve access to air ambulance services by updating Medicare's reimbursement rates. Passage of this legislation is a crucial step to addressing the access problem, Harrison and Templeton wrote. 

"We must do everything we can to protect and preserve healthcare access across the country—air medical services are a critical component," they wrote. "They are not an option, but a life-saving necessity." 

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Rural hospitals across the nation have faced financial woes, with more than 80 hospitals shuttering since 2010. Research suggests that one-third of rural hospitals are at risk for closure. When these hospitals close, it can have a devastating impact on the communities they serve.

There are some positive signs, however. Medicaid expansion may have prevented some cash-strapped hospitals from closing, according to a recent study, and Congress put a focus on rural healthcare in its 2018 spending bill

The Federal Communications Commission is also looking to expand its Rural Health Care Program to better support telemedicine programs that require a speedy internet connection. Telehealth, like air ambulances, is viewed as a key strategy to improve access to care in remote areas far from traditional hospitals.