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
                                  Source: Vertical IQ and Inforum

                                  Recent Developments

                                  Jul 6, 2024 - Moderate Sales Growth Expected
                                  • 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. Ambulance service industry employment and average wages for nonsupervisory employees increased slightly during the first quarter of 2024, according to the US Bureau of Labor Statistics.
                                  • 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.
                                  • Many fire departments that also provide emergency medical services (EMS) find that an increasing percentage of calls are for EMS. Just 4.5% of calls that came into Maine fire departments in 2022 were for fires, according to a Maine Monitor analysis of State Fire Marshal data. Almost three-quarters were for EMS. More than half of Maine’s 338 registered fire departments are also licensed at some level to provide emergency medical services, according to Maine EMS. The closure of ambulance services and lack of EMS responders in the state has prompted departments to consider training firefighters as medical personnel, according to the Portland Press Herald.
                                  • 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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