Timely blood transfusions can mean the difference between life and death.
Research shows that every minute of delay in accessing blood increases mortality odds by 5%. With more than half of trauma victims dying before ever reaching the hospital, every moment counts. However, a critical gap exists in our emergency medical services: most patients don't receive their first transfusion until they reach the hospital, regardless of transport time.
Prehospital blood transfusions benefit patients with severe bleeding, including trauma, postpartum hemorrhage, or aortic and brain aneurysms. However, due to outdated payment policies and scope of practice laws, the ability to carry and administer prehospital blood is limited.
The Percentage of Emergency Medical Services Currently Able to Carry and Administer Prehospital Blood Transfusions:
The Root of the Problem: Outdated Reimbursement Policies
The core issue lies with our insurance programs' payment policies. Currently, Medicare, TRICARE, Medicaid, and most private insurance plans have outdated bundled payment rates insufficient to cover the cost of the necessary infrastructure and blood components required for transfusions. This oversight creates a financial barrier that is insurmountable for many EMS’ where blood transfusions could have the greatest impact.
The Current Landscape:
According to data from the Centers for Medicare and Medicaid Services, between 1-2% of emergency medical services (EMS) currently carry blood for transfusions. Because of the lack of dedicated reimbursement through traditional insurance programs, these EMS’ must rely on local tax support or an organization capable of absorbing the increased cost.
The Call to Congress
To address this critical gap in emergency care, we are urging Congress to modernize our nation’s approach to prehospital blood transfusions by:
To address this critical gap in emergency care, America’s Blood Centers and its members are calling for Congress to include report language in the National Defense Authorization Act (NDAA) require the Department of Defense (DoD) to undertake an assessment of options for coverage of prehospital blood transfusions.
TRICARE is uniquely positioned to benefit from coverage for the transfusion of prehospital blood. TRICARE covers beneficiaries for a longer term than private insurance and can consider the whole cost of care for a patient encounter, including savings in hospital and follow-up care, to balance the increased ambulance costs. In addition, decreased mortality and disability saves the Department of Defense on survivor benefits and disability payments.
Furthermore, when a member of the military avoids disability or death, the DoD preserves the investment made in recruiting and training those personnel and avoids needing to recruit and train replacement personnel.
While other payers have begun to recognize the importance of supporting prehospital blood, DoD making this small change that will save lives, reduce healthcare disparities, and significantly improve our nation's emergency medical response capabilities. DoD can lead the way in supporting this lifesaving intervention.
We also urge members of the U.S. House to support the bipartisan Modernizing EMS Delivery and Sustainability (MEDS) Act and members of the U.S. Senate to introduce companion legislation.