Trauma is a leading cause of death in the United States, and timely blood transfusions can mean the difference between life and death.
Extensive research demonstrates that administering blood transfusions as soon as possible after a traumatic injury significantly improves patient outcomes. Prehospital blood transfusions can also benefit patients with medical conditions that result in severe bleeding, such as postpartum hemorrhage or aortic and brain aneurysms. 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.
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The Root of the Problem: Outdated Reimbursement Policies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 do not cover the cost of providing blood on ambulances. Outdated bundled payment rates are insufficient to cover the cost of the necessary infrastructure and blood components required for transfusions.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 emergency medical services where blood transfusions could have the greatest impact, preventing them from implementing this crucial capability.
The Current Landscape: A Matter of Inequality
Unfortunately, due to outdated payment policies and scope of practice laws, the ability to carry and administer prehospital blood is limited to between 1-2% of emergency medical services:
Those receiving grant funding
Services supported by local taxes
Organizations capable of absorbing the costs
This disparity creates a dangerous inequality in patient care, where access to potentially life-saving treatment depends on geography and funding rather than medical necessity.
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:
To remove financial barriers, we can ensure that all patients, regardless of location or socioeconomic status, have access to timely blood transfusions when needed most by updating federal insurance program payment polices to provide sufficient reimbursement for prehospital blood transfusions.
TRICARE is uniquely positioned to benefit from updated payment polices that sufficiently reimburse for the transfusion of blood since they cover beneficiaries longer term than private insurance, can consider the cost savings in hospital care to balance the increased ambulance costs, and when beneficiaries receive the benefits of decreased mortality and disability, the Department of Defense saves on survivor benefits and disability payments.