Ambulance Services
Industry Profile Report
Dive Deep into the industry with a 25+ page industry report (pdf format) including the following chapters
Industry Overview Current Conditions, Industry Structure, How Firms Operate, Industry Trends, Credit Underwriting & Risks, and Industry Forecast.
Call Preparation Call Prep Questions, Industry Terms, and Weblinks.
Financial Insights Working Capital, Capital Financing, Business Valuation, and Financial Benchmarks.
Industry Profile Excerpts
Industry Overview
The 3,000 ambulance services in the US provide ground or air transportation for patients in need of medical care. Companies typically have contracts with communities and government agencies to provide 911 emergency transports. While the majority of services are provided during emergency situations, ambulances may also be used for non-emergency transport.
Dependence on Third Party Reimbursement
Ambulance service companies provide services to patients, but receive the majority of payments from a variety of third parties, including government organizations, insurers, and managed care organizations.
Risk of Malpractice
Because ambulance service providers provide urgent medical care, companies are exposed to the risk of malpractice.
Industry size & Structure
The average ambulance service provider operates out of a single location, employs 55 workers, and generates $6 million annually.
- The ambulance service industry consists of about 3,000 companies that employ about 165,300 workers and generate $17.8 billion annually.
- The industry is concentrated at the top (the top 4 firms account for about 33% of industry sales) and fragmented at the bottom.
- Large companies include AMR, Acadian Ambulance Service, and Air Methods.
- Some ambulance service providers operate regionally, and most serve a limited geographical market.
Industry Forecast
Ambulance Services Industry Growth
Recent Developments
Nov 7, 2024 - Medicare Advantage Payment Updates Finalized
- Medicare payments to Medicare Advantage plans are expected to increase an average of 3.7%, or over $16 billion in 2025, according to the Centers for Medicare & Medicaid Services. Medicare Advantage plans cover emergency ambulance services, according to AARP. The finalized the Calendar Year 2025 Rate Announcement for Medicare Advantage is projected to result in payments of between $500 and $600 billion in Medicare Advantage payments in 2025.
- Two Raleigh County, WV, volunteer fire departments are requesting funds from the county to purchase ambulance equipment, adding to the increasing number of fire departments struggling to cope with the growing number of medical emergencies that volunteer fire departments are responding to. Coal City Volunteer Fire Department and the Bradley-Prosperity Volunteer Fire Department requested funds from the county’s ambulance fund to purchase ambulance equipment. “Bradley-Prosperity has doubled their 911 calls that they ran from last year to this year, and Coal City has probably close to quadruple the 911 calls that they run from last year to this year,” said Raleigh County Fire Coordinator Jason Whiting. “... In the fire service, the majority of the calls we’re running nowadays are a lot of EMS-based calls.”
- Washington State became the 16th state to pass consumer protections against surprise ambulance bills, according to Axios news. Just two states had some protections for ambulance bills in the 1990s, but momentum has grown since the US Congress exempted ambulances from the No Surprises Act, which was passed in 2020 to limit surprise medical bills. Four states passed ambulance billing laws in 2023 and more are considering legislation. State laws typically cap patient costs for out-of-network ambulance rides at what the patient would pay if it was covered by insurance, and health plans are responsible for the rest. More than half of ambulance rides are out of network, according to JAMA Network.
- Ambulance service industry employment and average wages for nonsupervisory employees increased slightly during the first nine months of 2024, according to the US Bureau of Labor Statistics. Ambulance service industry sales are forecast to increase at a 5.76% compounded annual rate from 2024 to 2028, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.
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