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 service companies 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 56 workers, and generates $5-6 million annually.

    • The ambulance service industry consists of about 3,000 companies that employ about 168,400 workers and generate $16 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
                                  Source: Vertical IQ and Inforum

                                  Recent Developments

                                  Mar 2, 2023 - Diesel Prices Remain Volatile
                                  • Retail diesel prices were decreasing in late February after rising steadily during January. The weekly US Department of Energy/Energy Information Administration price for February 27 decreased 8.2 cents a gallon to $4.294 a gallon. It was the fourth consecutive week in which the benchmark price used for most fuel surcharges fell and the 13th time in the past 16 weeks. The price dropped 32.8 cents a gallon during the previous four weeks.
                                  • Decreasing retail diesel prices have been driven by pump prices catching up with earlier declines in futures and wholesale diesel prices, according to trucking industry news site Freightwaves. Some analysts see price increases ahead, however. Goldman Sachs’ head of commodity research Jeffrey Currie expects higher prices by the end of 2023. “Our conviction in the bull case has never been stronger,” Currie said. He cited a lack of significant spare capacity in markets and low inventories for most crude and products, with the result that “you have no buffer to deal with the rebound in demand that is likely to come out of China. As China starts powering ahead, that is going to tighten up the bull market.” He also cited what he forecast as “strong” economic activity in Europe.
                                  • The federal Public Health Emergency (PHE) declaration for COVID-19 was renewed for another 90 days. The current declaration begins on October 13 (the date the PHE was previously scheduled to expire) and extends through January 11, 2023. The US Department of Health & Human Services (HHS) will provide states with 60 days notice prior to the termination of the PHE. Prior PHE renewals gave HHS the discretion to terminate the PHE at any time. Waiver of cost-sharing for medical and behavioral telehealth services by health insurers is likely to be extended again by insurers.
                                  • A partnership forged with a telemedicine provider may boost rural ambulance service. The partnership created by the state of South Dakota and Avel eCare telemedicine provider will connect EMS volunteers or employees to board-certified emergency physicians and registered nurses right inside the ambulance via video link. Experts say that many ambulance services rely heavily on volunteers, many of whom are also volunteer firefighters. Some volunteers don’t go out on calls very often, so the tool will help make them feel more confident in their treatment.
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