Rotary-wing (helicopter) or fixed-wing (airplane) air ambulances are sometimes used in emergencies to transport critically ill patients, often in life-threatening situations, to a hospital or for transportation between hospitals when patients need a higher level of care. In this report, FAIR Health uses both private and Medicare claims data to shed light on aspects of air ambulance services--both fixed-wing and rotary-wing--across the nation, including utilization, costs, age, gender, diagnoses that drive air ambulance use, differences across states, and outcomes of air ambulance transport as compared to ground ambulance transport. Among the findings: (1) Air ambulance claim lines increased 30 percent from 2016 to 2020 as a percentage of all ambulance (ground and air) claim lines (0.7 percent in 2016 to 0.9 percent in 2020). (2) From 2017 to 2020, average charges, estimated allowed amounts and Medicare reimbursements all increased for both fixed-wing and rotary-wing air ambulance transport. (a) The average charges associated with fixed-wing air ambulance transports rose 27.6 percent, from $19,210 in 2017 to $24,507 in 2020. The average estimated allowed amounts rose 76.4 percent, from $8,855 to $15,624. The average Medicare reimbursements rose 4.7 percent, from $3,071 to $3,216. (b) The average charges associated with rotary-wing air ambulance transports rose 22.2 percent, from $24,924 in 2017 to $30,446 in 2020. The average estimated allowed amounts rose 60.8 percent, from $11,608 to $18,668. The average Medicare reimbursements rose 4.7 percent, from $3,570 to $3,739. (3) In the period 2016-2020, air ambulance claim lines were predominantly associated with individuals 65 years and older. Patients in that age group accounted for 55.4 percent of claim lines for fixed-wing transport and 63.6 percent of claim lines for rotary-wing transport. (4) The top diagnoses associated with fixed-wing air ambulance rides from 2016 to 2020, as attributed by ambulance providers, were (from most to least common) digestive system issues; heart attack; sprains, strains, breaks and fractures; chronic respiratory diseases; and general signs and symptoms involving the circulatory and respiratory systems. (5) The top diagnoses associated with rotary-wing air ambulance rides from 2016 to 2020 were cerebrovascular issues and diseases, heart attack, head injury, injury to body and stroke. (6) The states with the highest use of fixed-wing air ambulance transport as a percentage of all medical claim lines in that state in 2020 (in order from highest to lowest use) were Alaska, Wyoming, South Dakota, Montana and New Mexico. The five states with the lowest use (in order from lowest to highest use) were Virginia, Kentucky, New Hampshire, New Jersey and Vermont. (7) Based on the origination point of the flight, the states with the highest average mileage for fixed-wing air ambulance transport in 2020 were Alaska (455 miles), Florida (444 miles), Georgia (429 miles), North Carolina (401 miles) and Indiana (382 miles). (8) The states with the highest use of rotary-wing air ambulance transport as a percentage of all medical claim lines in that state in 2020 were Idaho, South Dakota, New Mexico, West Virginia and Wyoming. (9) The states with the highest average mileage for rotary-wing air ambulance transport in 2020 were Hawaii (126 miles), North Dakota (115 miles), Wyoming (110 miles), Nebraska (94 miles) and New Mexico (90 miles). (10) In emergencies, in the period 2016-2020, patients transported by air ambulance were much more likely to be admitted as inpatients to a hospital than patients transported by ground ambulance. (11) In the period 2016-2020, the diagnosis with the highest inpatient admission rate after a fixed-wing air ambulance transport was newborn disorders. The diagnosis with the highest inpatient admission rate after a rotary-wing air ambulance transport was complications in newborns.
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