Air Methods, the parent company of LifeNet, the helicopter service providing emergency air transportation to patients in Kershaw County, says it can save county residents thousands of dollars if the county enters into its Community Partnership program.
Air Methods pitched its proposal to Kershaw County Council during its May 28 meeting.
The presentation began with KershawHealth Emergency Services Director April Wach, who previously contacted Councilman Jimmy Jones about Air Methods’ proposal. In introducing Wach, Jones said after sitting down with Air Methods representatives for about 15 minutes, he decided that their proposal was something both the entire council and the public needed to hear.
Wach said that one of the saddest things she recently experienced took place about two weeks earlier when a patient chose a course of action that could possibly result in their death instead of taking a helicopter ride to another facility because they were afraid the cost could force them to lose their home.
“South Carolina is third in the nation for fatalities due to car wrecks. That being said, accidents are the third leading cause of death in South Carolina, only to be topped by heart disease and cancer,” Wach said. “As of 2016, Kershaw County sits above the South Carolina average for motor vehicle deaths reporting 38 deaths for every 100,000 citizens versus the state average of 21 deaths for every 100,000 citizens.”
Out of LifeNet’s 124 air transports during 2018, Wach said 84 of them were from Kershaw County. Sixty-seven, she said were called by EMS in order to transport trauma patients during what is known as the “golden hour” during which their lives are more likely to be saved. Fifty-seven other patients were transported from KershawHealth to other facilities.
The average charge: $26,000.
LifeNet’s Jason Bober confirmed that in order for the Kershaw County-based helicopters to transport a patient, the hospital or EMS must make the request. Bober said crews consist of a pilot with more than 3,000 hours of flight experience, a nurse and medic.
Air Methods Outreach Coordinator Jeremy Roberts acknowledged that Air Methods and its subsidiaries, including LifeNet, deserved some bad press it has received in the past for its billing practices. In 2017, it launched a new patient advocacy program to correct itself.
“We realized that we were doing our billing practices wrong. We were very aggressive, almost heartless to the point of going after patients for the money for the flights. I’m here to tell you, we were wrong and recognized that we were wrong and we made that change, Roberts said, adding that the new patient advocacy was founded on the premise of walking patients “from the second we are dispatched to that patient all the way to getting that claim resolved with their insurance.”
Roberts said approximately 70 percent of its patients are either on Medicare or Medicaid and on fixed incomes, or are uninsured. This, he said, leaves the remaining 30 percent of self-pay or who have private insurance to cover the other patients’ costs.
Now that the company is “in-network” with more insurance companies -- approximately 30 to 35 percent of all major insurance companies in the country, he said, including Blue Cross Blue Shield of South Carolina (BCBSSC) -- more patients will be covered for emergency air transports.
Patient advocates are assigned based on what type of insurance the patient has: Medicare, Medicaid, and private insurance. Roberts said patient correspondence has also been simplified.
“As I said before, we as a company were wrong with how we were billing our patients, in working with our patients to get claims resolved. With the very first notice that went out to a patient, that notice included the total number of the bill, what the charge was to the insurance company, but didn’t tell whether that claim had paid or not. Oh, and here at the bottom, here’s a place for credit card information if you’d like to pay that,” Roberts said.
Now, he said, letters are sent that, first, express empathy for patients having to use their service and the name and direct phone number to a patient advocate. Additional correspondence takes the patient through the process and it is not until the fourth letter that patients see what financial responsibility the patient might have remaining after insurance.
Patrick Lamontagne, who said he had joined Air Methods as its South Carolina account executive a month earlier after working for the Red Cross for most of his career, then talked about the Community Partnership the company was proposing to council. Lamontagne said that, in the past, Air Methods required “memberships” in order for patients to take advantage of certain savings. He said that as the company began increasing its in-network status with insurers, leadership decided to shift to the Community Partnership program.
Lamontagne essentially said that the program has counties partner with Air Methods that, along with the increase in in-network status, he claimed, patients’ out-of-pocket expenses have been drastically reduced.
“With Medicare and Medicaid the reimbursements are completely set … so it’s not even necessary to have a membership for those patients,” Lamontagne said. “For those who are uninsured, our patient advocacy program utilizes flexible financial assistance programs to help minimize their out-of-pocket expenses. Nationally, patients transported by Air Methods since we have gone in-network and developed the patient advocacy program, they’re typically seeing an average out-of-pocket of $400 to $600 for their transport, which is quite significant compared to the overall cost that is incurred to run for a base to run the transports for those patients.”
Lamontagne said there are no upfront costs to the county or citizens. Instead, the county would set aside the funding it and Air Methods agree is necessary to cover those remaining out-of-pocket costs for patients. If by some chance no one from Kershaw County uses LifeNet services, then Air Methods would receive no money from the county that year. The more likely scenario, Lamontagne said, would be that fewer people use the service than estimated. If $50,000 were set aside, but only $30,000 were needed, then the county could either save that money or use it for something else.
Lamontagne said Air Methods has estimated that the per-transport amount for Kershaw County would be capped at $700 for out-of-network, private/self-insured or uninsured patients. Costs would drop to $225 per transport for in-network patients. Using those figures along with the history of flights from Kershaw County, he said Air Methods estimates the county should set aside approximately $33,200 in order to cover out-of-pocket expenses, figuring up a savings of more than $129,000 compared to the old membership fees.
And, he noted, that cost could come down further as BCBSSC further cements its relationship with Air Methods. He also said the partnership could be a good thing for the county as a sign of giving back to those citizens who are at the “point of real struggles in their lives.”
County Administrator Vic Carpenter pointed out that if council is interested in Air Methods’ proposal, the county would still have to go through normal procurement procedures by reviewing multiple proposals and then bringing back a recommendation to council.
Councilman Ben Connell also asked how many other South Carolina counties are part of the Community Partnership program. Lamontagne said that it is a new program the company is rolling out, but that he has spoken with Barnwell County. It was not clear if any of the counties LifeNet serves have signed on to the partnership.
Connell also suggested that if most of LifeNet’s patients are on Medicare, there might be a legislative remedy. However, Lamontagne claimed that the Community Partnership deal would be a “better solution” that other companies’ as well as versus the way Air Methods worked in the past.
Roberts also said that since Medicaid requires that there be no out-of-pocket expenses, such patients’ bills should end up zeroing out.
Councilman Sammie Tucker Jr. said he saw a similar Air Methods presentation at a S.C. Association of Counties (SCAC) conference and suggested the company approach the SCAC in order to reach out statewide.
Chairman Julian Burns said that he was “keen to hear” from county staff on the proposal as a business transaction. Jones asked that Carpenter keep an open mind, claiming that others on council had not done so and had tried to keep the May 28 presentation from being made.
Also during that meeting, council recognized the organizers and participants of the 2019 Ag+Art Tour that is coming up this Saturday and Sunday, June 8 and 9.
Camden-Kershaw County Tourism Partnership Director Suzi Sale said the tour is in its fourth year in Kershaw County and should several thousand people come here for the event.
“The Ag+Art Tour is a free, self-guided tour of farms and farmers markets featuring local artisans at every stop,” Sale told council. “Created by Clemson University in conjunction with our regional South Carolina Parks, Recreation and Tourism partner, the Olde English Tourism Commission, the tour has proven to be very rewarding.”
Sale then presented Burns with the Olde English commission’s “Attraction of the Year Award.” Burns, in turn, presented plaques to each representatives on hand from each participating sites and sponsor: Kathy McCaskill, Old McCaskills Farm and B&B Inn, Rembert; Stephanie and Hamilton Tetterton, Quite Content Farms, Camden; Jason Southers and Josh Slade, Goat Dadd’s Farm and Grade A Goat Dairy (with an actual goat in tow), Elgin; Tersa and Brian Motley, Raintree Farms and Jack Russell Rescue, Cassatt; Dorothy Butterton and Mackie Watson, Kershaw County Farmers Market, Camden; Wayne Belger, Boykin Mill Farms, Boykin, Spencer Floyd, loan officer, AgSouth Farm Credit, Lugoff; and Lauren and Thomas Reeder and Donald Branham, Triangle Hardware, Camden.