Citation

Chhabra KR, McGuire K, Sheetz KH, Scott JW, Nuliyalu U, Ryan AM. Health Aff. (Hope) 2020; ePub(ePub): ePub.

Affiliation

Andrew M. Ryan is the UnitedHealthcare Professor of Health Care Management, Department of Health Management and Policy, University of Michigan School of Public Health, and director of the Center for Evaluating Health Reform, University of Michigan.

Copyright

(Copyright © 2020, Project HOPE - The People-to-People Health Foundation)

DOI

10.1377/hlthaff.2019.01484

PMID

32293925

Abstract

"Surprise" out-of-network bills have come under close scrutiny, and while ambulance transportation is known to be a large component of the problem, its impact is poorly understood. We measured the prevalence and financial impact of out-of-network billing in ground and air ambulance transportation. For members of a large national insurance plan in 2013-17, 71 percent of all ambulance rides involved potential surprise bills. For both ground and air ambulances, out-of-network charges were substantially greater than in-network prices, resulting in median potential surprise bills of $450 for ground transportation and $21,698 for air transportation. Though out-of-network air ambulance bills were larger, out-of-network ground ambulance bills were more common, with an aggregate impact of $129 million per year. Out-of-network air ambulance bills averaged $91 million per year, rising from $41 million in 2013 to $143 million in 2017. Federal proposals to limit surprise out-of-network billing should incorporate protections for patients undergoing ground or air ambulance transportation.

Language: en

Keywords

Ambulances; Costs and spending; Emergency medical services; Health insurance; Health policy; Health services; Insurance providers; Medicare; Out-of-network billing; Out-of-network providers; Out-of-pocket expenses; Patient issues; Surprise billing