When Summit Healthcare in Show Low, AZ, lost its inpatient dialysis service and its two local nephrologists in 2016, it was no longer able to provide dialysis for patients who were hospitalized. Instead, Summit had to transport these patients to a hospital in Phoenix, Tucson or Flagstaff, where they could receive not only acute inpatient services but also inpatient dialysis. These transports, nearly always via air medical services, cost on average $42,000 per flight.
Word quickly got around the local dialysis community that if you were admitted at Summit for an inpatient stay (say for appendicitis or pneumonia), you would have to be transported to a metropolitan hospital so you could receive your needed dialysis as an inpatient. These patients started avoiding the Summit Emergency Department—and necessary healthcare—because they knew they would be flown out to a larger city.
