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Air Ambulances – 10 Year Trends in Costs and Use

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Air ambulances are either fixed wing (airplane) or rotary wing (helicopter) aircraft used to transport people in often time-sensitive medical situations. Air ambulances have become a frequent topic in the news due to their high cost and propensity to lead to surprise bills. Our analysis shows that although air ambulances are not frequently used and their use declined over the 2008 to 2017 period, the cost of an air ambulance trip is high and rising: the average price more than doubled from 2008 to 2017. To further examine this trend, HCCI analyzed the costs and use of both kinds of air ambulances by commercially insured people under the age of 65 who get their health insurance through their employer.

From 2008 to 2017, the use of helicopter ambulances declined from 34.2 to 29.3 trips – or 14.3% – per 100,000 people, while the use of plane ambulances remained relatively consistent at 4 trips per 100,000 people.

The average price of an air ambulance trip increased substantially over the 10-year period, rising 144% (from $11,414 in 2008 to $27,894 in 2017) for helicopters and 166% (from $15,684 in 2008 to $41,674 in 2017) for planes.

There is wide variation in the cost of air ambulance trips. In 2017, the 10th percentile of prices (measured as allowed amounts) for helicopter trips was $6,514 and the 90th percentile was $52,038. For plane ambulance trips, in 2017 the 10th percentile of prices was $6,642 and the 90th percentile was $79,350. The charges per air ambulance trip exhibit similar variation.

The cost of an air ambulance trip can be split into two components: the base rate and the mileage cost. In 2017, the mileage cost accounted for 35% of the total cost for a helicopter ambulance trip and 68% of the total cost of a plane ambulance trip.

The average mileage cost per trip increased faster than the base rate for both helicopter and plane ambulances. Explore the data using the interactive tool.

Methods Note

Air ambulance trips were identified in the HCCI dataset using Current Procedural Terminology (CPT) codes A0430 (plane/fixed-wing air ambulance base rate), A0431 (helicopter/rotary air ambulance base rate), A0435 (plane/fixed-wing air ambulance mileage), and A0436 (helicopter/rotary air ambulance mileage). An air ambulance trip was defined as all air ambulance services of the same type of transport – plane or helicopter – for a patient on the same date. Our 10-year (2008-2017) sample included over more than 100,000 air ambulance trips in the employer sponsored insured population under the age of 65. Trips with allowed amounts or charges of $0 or less were excluded from the analysis.