Johns Hopkins University researchers examined Medicare utilization and payment data for 2012-2016, including the number of air ambulance trips, type of medical specialty and provider name.
They found air ambulance charges, which do not factor in provider discounts or privately insured patients, were 4.1 to 9.5 times higher than what Medicare paid for the services in 2016.
Some of the largest air ambulance providers charged the most, according to the study.
Researchers said high charges could be reduced by encouraging new air ambulance providers to enter the market, but there may already be too many providers in the market because existing providers aren’t being used enough.
The study comes as states and federal lawmakers are trying to stop surprise medical bills that occur when patients unknowingly receive out-of-network care.
Researchers noted that states are not able to regulate rates, routes or services of air ambulance providers, per the Airline Deregulation Act of 1978.
Still, there are some federal efforts underway. Proposed Senate legislation would limit patients’ out-of-pocket costs for air ambulance transport to the in-network cost-sharing amount.
“Our results suggest that without congressional or regulatory effort to address air ambulance billing practices, patients — who in emergencies have few options and little bargaining power — are at risk of exposure to excessive charges,” the study authors concluded.
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