By Amy Leigh Womack
Northwest Florida Daily News (Fort Walton Beach, Florida)
Copyright 2006 Northwest Florida Daily News
Distributed by McClatchy-Tribune Business News
When Jimmy DuBose felt a throbbing pain in his chest in August, he knew he wanted to go to Fort Walton Beach Medical Center.
After suffering his first heart attack years ago, he had come to believe the hospital had a cardiac unit that could save his life.
That’s why the 65-year-old Crestview man asked emergency crews to take him from his house to Fort Walton Beach rather than to North Okaloosa Medical Center.
What he didn’t know was that his ride in a medical helicopter would cost more than $10,000 and that his wife, traveling by car, would arrive in time to watch him land. DuBose is aggravated and says he doesn’t understand why he wasn’t asked if he wanted to travel by air or informed upfront how expensive it would be.
“I’m just not paying it,” he said.
Medical helicopters take thousands of Panhandle residents to hospitals each year.
The helicopter companies say travel by air generally provides the quickest trip to hospitals best prepared to save patients’ lives.
But those trips are expensive, ranging on average from $7,000 to $10,000.
Express service
Emergency workers use helicopters most often to get patients to Pensacola hospitals that have trauma centers in situations where every minute is critical.
“If you don’t get the patient to a trauma facility in that golden hour, their chances are greatly diminished,” said South Walton Fire District Deputy Chief Sean Hughes.
The Emerald Coast is served by three medical helicopter providers, privately owned GULFlight and hospital-based AirHeart and Baptist LifeFlight.
AirHeart and Baptist Life-Flight fly patients across the Panhandle and sometimes into Alabama.
GULFlight, owned by LifeNet Inc., is based at Twin Cities Hospital in Niceville and logs most of its flights in Okaloosa County.
Patients involved in bad car accidents and children with serious medical problems are among those typically taken to the hospital by air rather than by ambulance.
Dr. Chris Tanner, medical director for Okaloosa County Emergency Medical Services, said helicopters provide the fastest and most reliable trips because they can bypass traffic lights and gridlock.
In Okaloosa County, EMS shift Capt. Darrell Welborn said patients having a heart attack or stroke symptoms are generally taken to specialists at Fort Walton Beach Medical Center.
While ambulances usually can take south county residents, Welborn said a helicopter is often needed to get heart attack and stroke patients in north Okaloosa to the hospital quickly.
“Time is muscle and time is brain tissue,” said Welborn, who also works for GULFlight.
But a helicopter doesn’t always ensure a speedy trip.
In DuBose’s case, the dispatch log shows a 911 call was placed at 10:02 a.m. An EMS crew put a GULFlight helicopter on standby at 10:04 a.m. and an ambulance arrived at DuBose’s home 10:12 a.m. The log shows the helicopter was launched at 10:31 a.m., almost 30 minutes after the 911 call.
DuBose said his wife left for Fort Walton Beach at about 10:40 a.m. as he rode in the ambulance from his home to Bob Sikes Airport about a mile away to meet the helicopter. The helicopter took off at 11:02 a.m., an hour after the 911 call was placed, according to the log.
Tanner said the helicopter was delayed because the EMS crew waited for clearance to bypass North Okaloosa Medical Center and take DuBose to Fort Walton Beach instead.
He said it also takes time to load patients into an ambulance, drive them to a helicopter landing site and then put them into a helicopter. Tanner said the hour it took to get DuBose loaded onto a helicopter is fairly typical for patients having medical problems at their homes.
Anywhere from 35 minutes to an hour can pass between when someone dials 911 until they’re loaded into a helicopter, he said.
“We shoot for the shortest time possible,” Tanner said. “But if there’s any kind of talking being
done (about where to take the patient) it delays things.”
Sky-high costs
Recovering from bypass surgery at home, DuBose said he was surprised when a bill arrived in the mail for $10,123.73 for a service he said he would have refused had he known the cost.
“It came as a complete shock,” he said. “They should apprise people of the costs.”
DuBose said his wife pulled into the hospital parking lot in time to see the flight crew unload him from the helicopter.
He said it seems that an ambulance would have made the trip in about the same time as his wife, if not quicker.
And for less money.
Helicopter companies say it’s up to emergency responders on the ground to tell conscious patients and family members that they’ve called a helicopter.
“If they’re conscious they have the right to refuse service,” said Ron Mosley, AirHeart’s director of transport services.
But local ambulance services say that although they make a point to inform conscious patients and their families of plans to fly them, they don’t necessarily ask if that’s what a patient wants.
That was the case with Du-Bose. He said he remembers being told that he was being taken to a helicopter, but he wasn’t asked if it was OK or told how much it would cost.
As a whole, helicopter companies say few people refuse to fly.
But some do.
“Usually it’s not because of the bill,” said Baptist LifeFlight Program Director Kevin Stanhope. “It’s that they’re afraid to fly.”
Flight costs vary widely among the three companies.
Mosley said helicopter services begin with a base fee of $5,800 in addition to $72 per mile.
Although Craig Yale, LifeNet’s vice president of business development, said he couldn’t provide exact GULFlight costs due to competition, DuBose’s bill shows a base charge of $8,551.45.
DuBose was charged $61.97 per mile for his 24-mile trip from Bob Sikes Airport to Fort Walton Beach Medical Center, according to his bill.
He also charged for medical supplies.
Although Stanhope also said he couldn’t divulge actual rates for LifeFlight, he said an average flight costs $7,000.
All three companies say they aren’t making large profits.
“My end-of-the-month goal is to be able to break even,” Mosley said.
Yale said GULFlight’s helicopters cost about $4 million
He said personnel costs are high, with well-trained pilots and experienced medical personnel. The companies also pay high insurance costs in addition to their own training and dispatching, he added.
In most cases, helicopter service representatives say patients’ insurance companies pick up the tab. “Rarely do we ever have a denial,” Mosley said.
But not everyone has health insurance.
Stanhope said between 18 and 20 percent of LifeFlight patients don’t carry insurance.
On average, the company collects about 47 cents on the dollar from patients services, he said.
“We have historically lost money while operating this program,” said Stanhope, who added that LifeFlight is one of the oldest hospital-based medical helicopter companies in the nation. It will celebrate its 30th anniversary next year.
For GulfFlight, Yale said the percentage of people who can’t pay is much higher.
“About half the patients don’t have the ability to pay the bill,” he said.
Mosley said AirHeart has patients who are paying as little as $20 a month on their bills while others don’t pay at all.
“It’s a total loss,” he said.
“At least you’re alive”
Even with the high cost of flying, helicopter companies and emergency officials say it’s worth the bill if patients survive.
“We realize there’s a bill attached,” said Hughes, the deputy chief for South Walton fire. “But it’s just a bill. At least you’re alive to pay it.”
Helicopter companies say many patients actually save money by getting to the hospital faster.
“It’s been proven that patients who arrive at the appropriate facility quicker have a shorter length of stay in the hospital or in the ICU,” Stanhope said.
But Mosley said flying has the potential to save more than money.
“How much is 20 or 30 percent of your heart muscle worth?” he said. “How much is every square inch of your brain worth?”