Happy 2015 to the AAMS Membership!
AAMS spent much of last year working with the co-chairs of the Congressional Air Medical Caucus in developing draft legislation to address the growing discrepancy in Medicare reimbursement for air medical transports. With the new 114th Congress now underway, we are in the final stages of that process and anticipate a bill being introduced by the end of January if all stays on track. While final details are still being determined, the bill will establish a process that will allow for the collection and analysis of aggregate industry operational costs that will, in turn, allow for future Medicare reimbursement rates that better reflect actual costs.
The legislation will also provide more immediate financial relief to bridge the gap until the cost reporting and analysis process is completed. Finally, it is expected the legislation will adopt a process for monitoring a set of reasonable commonly-collected quality measures. I am excited to see this legislation come together. If enacted, this bill will benefit every air medical provider conducting Medicare transports, or any transport whose payment plan mirrors Medicare payments.
As we expect a January introduction of the bill, we are organizing an AAMS Hill Fly-In day, on February 11th, for AAMS members to come to Washington to help rally support for our Medicare efforts. Logistics are being ironed out and will be available in the very near future. In the meantime, please save February 11 on your calendar and plan to join us in Washington, DC. It is essential you lend your voice to this critical industry effort!
I’d also like to formally announce the launch of the MedEvac Foundation International’s second Economic Impact Study. Our second study is focused exclusively on hospitals and hospital-based medical transport programs, and will examine the impacts that air medical transport and critical care ground transport programs have on the hospitals they serve. Data will be collected from a cross section of hospitals throughout the US that are representative of different specializations including pediatrics, oncology, cardiac, and more. AAMS hospital-based members should keep their eyes out for the Foundation’s request to facilitate involvement from the facilities you serve. A comprehensive outcome depends on the participation of your hospitals. Please help us by strongly encouraging their participation in the study.
In closing, I want to touch upon recently published research in the Journal of Trauma and Acute Care Surgery entitled “Probable cause in helicopter emergency medical services crashes: What role does ownership play?” That study appears to imply that public aircraft operating under a HEMS profile are a safer alternative to “commercial providers,” which by their definition includes for-profit operators as well as not-for-profit programs utilizing a for-profit aviation vendor. The Journal of Trauma article was followed up by back-to-back stories in the Bend Bulletin in Oregon that further sparked my concern. Both the research and the news stories imply the aviation and patient safety records of commercial providers are directly affected by fiduciary pressures. I think it is very important to point out that “fiduciary care” is a fundamental business concept. All air medical providers have financial responsibilities, whether they answer to owners, shareholders, a non-profit Board of Directors, or taxpayers. The same holds true for hospitals, doctors, other medical providers, and any other for-profit or not-for-profit business of any kind.
Further, there is very little mention of our industry’s voluntary investment, to the tune of hundreds of millions of dollars, in operational and safety improvements such as night vision goggles, helicopter terrain awareness warning systems, operational control centers, auto-pilot systems, as well as climate control, flight data monitoring and quality assurance programs. Nor is there any emphasis on the implementation of vigorous Safety Management Systems (SMS), and greatly improved education and training in the area of human factors. SMS, as well as ongoing education and training, continues to combat complacency and increase personal accountability. The result is an industry-wide safety culture that reaches across all business models – a culture that was fostered voluntarily and unilaterally, while the industry awaited the publication of the FAA Final Rule, a rulemaking process that took over three years to complete.
Air Medical Services are a vital healthcare safety net for tens of millions of Americans. We owe it to the patients we serve to have an open and honest dialogue on safety. While we should not ignore mistakes of the past, we should also not ignore the tremendous strides the industry has taken over the past several years to improve our safety technology and processes. Neither aviation accidents nor medical errors are new or unique to the air medical community. Safety is a journey, a continuous pursuit of excellence, not a destination. We must continue down a vigilant road exploring emerging safety technologies, operational improvements, and high-quality, effective education and training. We must also be cognizant that, while our industry has its share of competition like any other industry, the public-at-large does not easily differentiate between competing programs or business models. Any publicity received, positive or negative, affects everyone in the industry. In short, we all have an interest in building the strongest and safest industry possible. That is why an appropriate illustration of facts, both historic and current, is just as important to this industry as the lifesaving services that AAMS members provide to patients around the world.
AAMS is extremely proud to be the trade association for the air medical and critical care ground community and embraces all of the myriad business models within our membership. We remain committed to helping our members provide safe, high-quality transport and high-quality, patient-focused medical care to every patient-in-need. We look forward to a wonderful and productive 2015!
President & CEO, Association of Air Medical Services and MedEvac Foundation International