Come August, It'll Be Much More Expensive To Get Rescued By Helicopter In Travis County

AUSTIN, TX — Come August, it will become more expensive—exponentially more costly—to get rescued by helicopter in Travis County.

The Travis County Commissioners Court on Tuesday authorized STAR Flight to "revise the reimbursement practice for patients who are transported by STAR Flight," county officials said in a news advisory. STAR Flight officials explained the low reimbursement rate for past services prompted them to revise the rates in order to help recover costs.

In plain English, the cost for medically needed helicopter ride is about to get much more costly with the new base rate for service set at $15,500 and $200 per mile, according to a news advisory. That new base rate represents an $11,000 cost increase for county residents, officials said.

"This change will assist the county in collecting the Usual Customary and Reasonable (UCR) rate of reimbursement from insurance services," officials explained. "Currently, the county does not receive the reimbursements that are consistent with rates routinely paid to other air ambulance providers in Texas."

In an email sent to Helena Wright, the public information officer for the Travis County Emergency Services, Patch asked what the current rate is: "The current base rate for a Travis County resident is $4,500 and for a non-Travis County resident the base rate is $9,500," Wright wrote. "The rate per mile for both is $165. Effective August 1 of this year, the base rate will be $15,500 across the board at $200 per mile."

Josh Davies, the county executive of emergency services, conceded the likelihood of recovering owed reimbursement is negligible: "It's not likely that we will ever be able to receive a reimbursement that will cover the actual cost of services provided by STAR Flight," Davies said. "Adjusting our costs and seeking full insurance payments will help decrease the impact on the county general fund."

As part of the fees schedule revamping, STAR Flight will issue a bill only if a patient is transported to a hospital, officials told commissioners. There is no charge for a response, fire suppression, law enforcement or search-and-rescue services, according to officials.

In an emailed response to questions from Patch, Wright explained further: "If STAR Flight rescues someone from a flood situation and drops off with family, law enforcement or EMS at the scene and not to a hospital, then that person is not billed," she wrote. "However, if someone falls near the greenbelt and is injured, STAR Flight would rescue that person and transport to a hospital. The patient is not billed for the rescue, but is billed for the transport to the hospital."

One officials said there might be some state funding earmarked for fire suppression: "There are some situations where limited funding may be available if approved by the state for fire suppression," Casey Ping, STAR Flight program director, said. "STAR Flight operates as both a commercial air ambulance service and as a public service helicopter service."

In justifying the cost hike, Travis County Commissioner Gerald Daugherty explained how costly it is to offer the medical helicopter rescue service.

"It's very expensive to provide these critical life-saving services to the region," Daugherty explained. "We must also seek to recover all available reimbursements from insurance services."

The ability to increase revenue through "better reimbursement" can help limit the impact of the service on county residents' tax bills, officials said. Officials estimated roughly 20 percent of STAR Flight's patient transports are uncompensated and, generally, only a portion of the billed amount is paid by insurance companies, officials noted.

Despite the price hikes, STAR Flight officials still will make accommodations to those unable to afford the service while basing a bill on patients' insurance providers, Chuck Spangler, STAR Flight director of operations, said.

"We realize that the cost of air ambulance is expensive, the patent is usually not able to make a decision to be transported in a helicopter when they are ill or injured," Spangler said. "We understand that and need to provide relief to those who are not able to pay."

The air medical transport industry is largely unregulated, with no federal requirements to track or report fees, as NBC News reported last year. But fees range from $12,000 to as high as $25,000 per flight, a spokesman for the nation's largest provider of air medical transport systems, Air Methods Corp., told the news station.

By comparison, ground ambulance service is exponentially less expensive from $800 to $2,000 for an average trip, according to the American Ambulance Association.

While life saving is the mission of medical air transport and the work of rescuers at times truly heroic, such providers are businesses focused on the bottom line. What it comes down to is a matter of dollars and cents: “We’ve got to collect enough money for the service, or the service goes out of business,” Dr. Kevin Hutton, a San Diego emergency room doctor who founded Golden Hour Data Systems, Inc., a medical billing system for air providers, told NBC.

Patients transported via medical helicopter often get sticker shock when seeing their bills. But the last thing on the mind of someone needing rescue is to inquire about price, and rescuers swooping down to them likely don't offer the list of fees given their rescue focus.

To help describe the rough calculus of revamped STAR Flight costs in Travis County, officials released a Frequently Asked Questions compilation:

I was transported by STAR Flight, why did I receive a bill from Intermedix?

Intermedix is the third party medical billing company that Travis County uses to perform STAR Flight billing services.

I am a Travis County resident and have paid my property taxes. Why did I receive a bill for services?

STAR Flight is a service offered by Travis County to protect and serve its residents and visitors. Since its inceptionin 1985, STAR Flight has been funded through a combination of tax revenue and user transport reimbursements. STAR Flight is an FAA approved Part 135 air carrier operating as a commercial air ambulance service. Charges for services rendered are collected from users of the service that are transported from the scene of an emergency or medical facility to a hospital.

If STAR Flight responds to the scene of an emergency but does not transport me to a medical facility, do I have to pay a fee?

STAR Flight only bills for the services it renders. For example, STAR Flight would charge a user who was transported from one medical facility to another.

I read that Travis County increased fees for medical transport. Why was this necessary?

The reimbursements that STAR Flight received in 2016 were below the usual customary and reasonable rates that other medical transport providers within the Central Texas region charged. STAR Flight's revised fee structure reflects what other medical transport providers charge and will help to offset the cost Travis County taxpayers for providing STAR Flight services,

Does this mean that I won’t get a bill for a STAR Flight transport?

The revised reimbursement structure allows STAR Flight to maximize revenue from third party sources (e.g.,insurance companies, Medicare, Medicaid and other payers), while relieving un- and under-insured users fromthe obligation to pay for charges in excess of their co-pay amount or deductible, if any. Patients are responsible for paying all insurance or program-required co-pays or deductibles. However, once all third-party sources have been exhausted, users who are un- or under-insured and have provided the appropriate documentation to STAR Flight will not be required to provide further reimbursement unless he or she received a settlement as a result of the injury or illness that led to the transport. In the event the user receives compensation or a settlement as a result of an injury or illness, Travis County reserves the right to seek full reimbursement for the services that STAR Flight provided.

>>> Photo credit: Tobias Klenze via Wikimedia Commons