- The global ambulance services market is on track to reach $48.9 billion by 2025, growing at a compound annual growth rate of 9.1%, according to an analysis by Grand View Research.
- Driving growth are an aging population prone to heart attacks and other cardiovascular events, favorable payment policies, increased medical tourism and an uptick in automobile accidents.
- Emergency services and advanced life-support ambulance services are expected to dominate the market during the forecast period, the report says. Major U.S. players include Envision Healthcare and America Ambulance Services.
In the U.S., Medicare reimburses for both emergent and non-emergent transport services so long as they are medically necessary and the ambulance supplier complies with Medicare requirements.
Under Medicare, ambulance services are considered medically necessary “if they are furnished to a beneficiary whose medical condition is such that other means of transportation are contraindicated. In any case in which some means of transportation other than an ambulance could be sued without endangering the individual’s health, whether or not such other transportation is actually available, no payment may be made for ambulance services.”
CMS has cracked down in recent years use of ambulances for non-emergent transport. For example, in 2015, nine Florida hospitals and an ambulance company agreed to pay the federal government $7.5 million to settle charges they defrauded Medicare by billing for unnecessary ambulance rides.
Private insurers with policies limiting reimbursement of non-emergent medical conditions have met with pushback from providers.
Last summer, the American College of Emergency Physicians and its Missouri chapter sent a letter to the state’s insurance director seeking a review of Anthem’s emergency department policy of not paying for emergency services it considers unnecessary. The ACEP argued nearly 2,000 diagnoses that Anthem listed as non-urgent could be life-threatening or lead to further health problems.
With the trend toward population health, providers have partnered with on-demand transit companies like Uber and Lyft to get non-emergent patients to and from appointments, cutting down on cancellations and no-shows.