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
Mar 6, 2025 - Services Struggle With Reimbursement, Staffing Issues
- Staffing shortages and reimbursement prices for ambulance transports are negatively impacting ambulances services, according to The Jamestown Sun. “We've got a reimbursement issue, which means we have a revenue issue, which means we have an employee issue,” said Andrew Berkey, operations manager for Jamestown (North Dakota) Area Ambulance. The cost of operating an ambulance service has increased 66% over the last decade but reimbursement over that same period has increased 12%, according to Adam Parker, who advocates for ambulance services across the state. A recent federal study shows that the average cost of an ambulance transport is about $2,670 while the average reimbursement for that was about $1,140, according to Parker. “We only get paid for transport in most scenarios,” Parker said. “So if we respond to somebody who called 911 and we don't transport them, many insurance providers don't reimburse for that call.”
- Insurers’ losses on medical malpractice claims have increased rapidly in some states since 1998, according to a US General Accounting Office (GAO) report. The increased losses appeared to be the greatest contributor to increased premium rates, according to the Medical Malpractice Insurance: Multiple Factors Have Contributed to Increased Premium Rates report. The American Medical Association cited the report as evidence of the need for tort reform and as a refutation of claims by opponents of reform, especially the trial lawyers association, who say that the real reason for rising rates has to do with insurance company investment strategies. Those opponents say that insurance company premiums were artificially low during the bull-market years of the 1990s, when insurance companies were reaping profits from investments. Rates are rising now to cover losses as investment income has decreased.
- 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.
- Ambulance service industry employment decreased slightly and average wages for nonsupervisory employees increased slightly during the first month of 2025, 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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