AMU Emergency Management Original Public Safety

Can We Eliminate Surprise Billing for Emergency Services?

By Allison G. S. Knox
Contributor, EDM Digest

Emergency managers and other professionals want the general public to have a good understanding of emergencies, preparedness and emergency operations, because that would essentially make emergency management easier for all.

Start an Emergency & Disaster Management degree at American Military University.

But emergency managers and elected officials are often government employees, and it should be no surprise that trust in government — particularly during an emergency — can be compromised.

Recently, there has been a lot of discussion about so-called surprise medical bills. This is an important policy issue, because so many people have been hit by emergency room medical bills they cannot afford to pay even with health insurance. At the forefront of the discussion are issues surrounding excessive air ambulances and ambulance bills.

Do ambulance and air ambulance services engage in predatory billing practices? Even if they do not, will extraordinarily high emergency bills further harm trust in government and create problems for emergency management in the long term?

Surprise Medical Bills Are Growing at An Alarming Rate

This quandary has affected the emergency medical services community, because Americans are receiving surprise medical bills for the ambulance services at an alarming rate. Kaiser Health News has even suggested that some people are afraid to take an ambulance during an emergency, fearing an excessive bill down the road.

Recently, the Journal of Emergency Medical Services (JEMS) reported that air ambulance services are creating memberships policies to help manage emergency patient care in rural areas. Patients will not receive surprise medical bills if they used an air ambulance, because they had prepaid for the service through their membership.

In many respects, this is simply a way for residents to prepare for potential medical or trauma emergencies, and it would certainly mitigate surprise medical bills. In many ways, the concept follows the appropriate guidelines for emergency management principles.

But not everyone sees these memberships as financially worthwhile. But the JEMS article notes that memberships can be cancelled at any time.

These excessive billing practices were also illuminated when the Washington Post explained that the UVA Health System allegedly was targeting families with predatory billing practices that forced those families into bankruptcy when they couldn’t pay their medical bills.

These practices not only create astonishingly high medical bills, but they can also create situations that make patients feel they cannot trust medical professionals. It’s an issue that can spill over into the emergency management world.

Billing Is Creating Trust Issues in the Government

Medical care is an essential component of emergency management; it is one reason why it is listed as an Emergency Support Function. Fear of surprise medical bills because of what others have been experiencing could create issues of trust in government, particularly when emergency medicine and emergency management are concerned.

The Problem Won’t Be Solved Soon

While this is certainly a devilish problem that will not be solved soon, it is strategically important for emergency managers and other stakeholders to carefully follow discussions about surprise billing. It is imperative for them to offer input for positive policy initiatives that may correct some of the pitfalls associated with surprise medical bills especially as they affect ambulance and medevac emergency services.

That might also strengthen the overall perception of emergency management.

Allison G.S. Knox

Allison G. S. Knox teaches in the fire science and emergency management departments at the University. Focusing on emergency management and emergency medical services policy, she often writes and advocates about these issues. Allison works as an Intermittent Emergency Management Specialist in the Administration for Strategic Preparedness and Response. She also serves as the At-Large Director of the National Association of Emergency Medical Technicians, Chancellor of the Southeast Region on the Board of Trustees with Pi Gamma Mu International Honor Society in Social Sciences, chair of Pi Gamma Mu’s Leadership Development Program and Assistant Editor for the International Journal of Paramedicine. Prior to teaching, Allison worked for a member of Congress in Washington, D.C. and in a Level One trauma center emergency department. She is an emergency medical technician and holds five master’s degrees.

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