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Wash. MedStar on a mission

KENNEWICK, Wash. Roger Wright credits Northwest MedStar for saving his life. About two years ago, a MedStar aircraft flew him to Seattle's Harborview Medical Center after doctors at Richland's Kadlec Medical Center referred him there. A cyst on Wright's brain stem had burst a day earlier.

A weeklong stay in the intensive care unit nursed him back to health. But he shudders to think what would have happened in absence of the air ambulance service run by MedStar, which is part of nonprofit Inland Northwest Health Services and has a base in Richland.

"I was somewhat conscious," said the 46-year-old Wright, a contract engineer with the Port of Benton.

His insurance only partly covered the transportation expenses, which amounted to about $14,000. In the end, he managed a few discounts after negotiating with Kadlec and MedStar to bring down his out-of-pocket expenses to $7,500.

For many, the cost would be too heavy a financial burden. It's an all-too familiar story at Northwest MedStar, which wrote off almost $17 million of its $33 million gross revenues in 2006 because of Medicare/Medicaid shortfalls and patients' inability to pay, said Nicole Stewart, director of communications and marketing, Inland Northwest Health Services.

So, about six months ago, MedStar began a membership program designed to save patients from exorbitant co-pays related to critical air-transport services.

The program costs $59 a year or $150 for three years and covers the member, spouse and any dependents listed on income tax returns. It bills a members insurance company directly and takes care of nonreimbursed flight charges. With partnership agreements with other regional air ambulance services, MedStar's service area extends to Wyoming, northern California, and parts of Nevada and Montana in addition to core areas of Washington, Oregon and Idaho.

Last year, the Tri-Cities base helped transport about 916 patients, a third of the total, to various hospitals.

Wright, of Pasco, plans to sign up for the program, but he hopes he never has to use it. "It's cheap insurance," Wright said.

About 600 people already have become members, said Eveline Saltmarsh, director of Northwest MedStar. Membership dues help cover the cost of the program, she said, adding it's a community benefit.

"If everybody pays a little then nobody pays a lot," she said.

The program is being targeted at rural communities, Saltmarsh said.

The program became a possibility after a new state law granted air ambulances necessary exemption from insurance regulations, Stewart said. MedStar's fleet in Richland includes a small twin-engine King Air 200 and a helicopter equipped with life-support systems and a trained crew of pilots, nurses and respiratory therapists.

The chopper provides a point-to-point service, which could mean flying patients in need of critical care from one hospital to another or out of remote areas. The plane can fly in inclement weather and is generally more cost-effective for long-range travel, Saltmarsh said. The decision to use either of the options is based on several factors, including a patient's medical condition, she said. MedStar wants to provide a fast, reliable service to clients, she added.

The crew is on duty 24/7 and the aircraft or helicopter are ready to fly within minutes of a call, said Adult Flight Nurse Carolyn Prouty, who recently took over as base lead for the Tri-Cities operations.

Prouty plans to coordinate emergency and medical training system in partnership with local hospitals and regional emergency management services council to make MedStar more efficient.

Roger Casey, trauma coordinator at Kadlec, said MedStar's medical team meets with the center's emergency care providers once a month.

The interaction is geared to improving services, said Casey who has worked in Kadlec's emergency care for more than a decade and dealt with other air ambulance services as well.

About 80 percent of MedStar's calls are generated by doctors and the remaining are initiated by 911 emergency responders, Saltmarsh said.

Connie Pitts, RN director for emergencies at Kennewick General Hospital, said patients with critical injuries such as amputation, pelvic fractures, or neurological complications often are moved to Seattle or Spokane hospitals. Most cardiac patients are referred to Kadlec as soon as doctors can stabilize their condition, Pitts said.

Air ambulance crews are specially trained to deal with a range of sickness levels and provide necessary care, she said. "MedStar is an asset for the community," she said.

Her view is seconded by Kadlec Medical Center's Dr. John Matheson who specializes in emergency medicine.

There is a significant rural population living in isolated areas is Eastern Washington and a MedStar base in the Tri-Cities can help take care of medical emergencies if needed, he said.

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