Why Are Ambulances So Expensive?
Ambulances and the equipment and people who staff them don't come cheap. A typical vehicle can cost $125,000 to $150,000, and some models can be even pricier. The cardiac monitor that keeps heart patients safe on the way to the hospital typically runs another $40,000, and a device called a LUCAS compression machine, which applies better compressions to a cardiac arrest patient than a human EMT or paramedic could, runs around $15,000. Even a stretcher can cost $20,000 [source: Mendelowitz].
Those costs, coupled with the increasing tendency of municipalities to contract out their EMS services to for-profit companies, can make even short ambulance rides expensive. And health insurance companies don't always cover the costs.
NBC News reported in 2018 on the case of a teenage boy who was transported to the hospital (a ride of less than 2 miles [3.2 kilometers]) with what his doctor initially feared was a punctured lung, though it turned out to be a pulled muscle. Even so, the teen required extensive care along the way, and insurance would cover only $400. To their shock, the family received a bill for $2,400, though the ambulance service eventually agreed to reduce it to $1,600. The boy's parents didn't realize that a private ambulance service would be picking him up when they called 911 [source: Thompson].
Many patients have been shocked by the bills they receive for their ambulance trips to the ER. EMS systems counter that having all the equipment we mentioned earlier on board (even if it's not used in a particular case) is expensive. And ambulance services are generally only reimbursed for ambulance rides to a hospital, but the EMTs and other personnel are paid hourly by the service even if they don't have any calls that day, since they have to be on call with no time to spare.
Further, reimbursement rates from Medicare and Medicaid haven't changed in the last 20 years. Medicaid, in particular, pays 40 percent below what an ambulance ride costs. Insurance companies want to reimburse at Medicare/Medicaid rates and no more, leaving the patient on the hook for the difference. Ambulances also use private customers to "subsidize" the Medicaid and Medicare costs [source: Mendelowitz].
One solution would be for states to pass laws that would protect consumers from "balance billing" by out-of-network ambulance companies for balances beyond what their insurance companies cover. But a 2017 study by the Commonwealth Fund found that only six states offered such protections [source: Lucia, Hoadley, and Williams].
So how can you protect yourself from a high ambulance charge? If you're not encountering a life-threatening situation, you may wish to have a friend drive you to the hospital, or call a taxi or ride-sharing service, as opposed to calling 911. And it wouldn't hurt to look at your insurance policy ahead of time to know how much you're covered in case you ever need to call on the expertise of ambulance services.
Author's Note: How Ambulances Work
When I was just a few years out of college, several of my friends worked as EMTs, and I was always fascinated by the stories they told of their work. That made it more interesting for me to research this article.
More Great Links
- American College of Emergency Physicians. "Rural Patients Wait Longest for EMS." Newsroom.acep.org. July 19, 2017. (Dec. 12, 2018) http://bit.ly/2rxhqbB
- America College of Surgeons, etal. "Equipment for Ambulances." Facs.org. April 2009. (Dec. 12, 2018) http://bit.ly/2ryEx5x
- Bailey, Melissa. "Not Covered by States' Surprise Medical Bill Laws? Ambulance Rides." Kaiser Health News. Nov. 27, 2017. (Dec. 10, 2018) http://bit.ly/2rAQ0Bn
- Bell, Ryan Corbett. "The Ambulance: A History." McFarland & Company. 2009. (Dec. 12, 2018) http://bit.ly/2GpJfgn
- Buchle, Scott, program manager, Penn State Health Life Lion EMS, Hershey, Pennsylvania. Telephone interview. Dec. 10, 2018.
- Haller, John S., Jr. "Battlefield Medicine: A History of the Military Ambulance from the Napoleonic Wars Through World War I." Southern Illinois University Press. 2011. (Dec. 12, 2018) http://bit.ly/2GcpzMx
- Lucia, Kevin; Hoadley, Jack; Williams, Ashley. "Balance Billing by Health Care Providers: Assessing Consumer Protections Across States." Commonwealthfund.org. June 13, 2017. (Dec. 12 2018) http://bit.ly/2rAQMON
- McCallion, Teresa. "NASEMSO Survey Provides Snapshot of EMS Industry." Journal of Emergency Medical Services. Nov. 15, 2011. (Dec. 12, 2018) http://bit.ly/2rAxetY
- Mendelowitz, Josh. "Here's Why Ambulances Are So Expensive." HealthCare.com. Nov. 30, 2018. (Dec. 12, 2018) https://www.healthcare.com/blog/why-ambulances-expensive/
- Olsen, Patricia R. "His Job Is Saving Lives When Others Are Sleeping."New York Times. July 13, 2018. (Dec. 12, 2018) https://nyti.ms/2ryg405
- Pollock, Alexander. "Historical Perspectives in the Ambulance Service." Chapter from "Ambulance Services." Springer. 2015. (Dec. 12,2018) https://www.springer.com/cda/content/document/cda_downloaddocument/9783319186412-c1.pdf?SGWID=0-0-45-1527370-p177371080
- Smith, Noah. "A National Perspective on Ambulance Crashes and Safety." EMSWorld. Sept. 3, 2015. (Dec. 12, 2018) http://bit.ly/2GfKdf3
- Thompson, Anne. "High ambulance costs surprise families in times of need." NBC News. March 6, 2018. (Dec. 12, 2018)https://nbcnews.to/2ryek73
- Weston, Bob, MD, MPH. assistant professor of EMS medicine, Medical College of Wisconsin. Email interview. Dec. 7, 2018.
- Wharton, Kit. "Emergency Admissions: Memoirs of an Ambulance Driver." HarperCollins UK. 2017. (Dec. 12, 2018) http://bit.ly/2GdCKgq