Ground ambulance costs rose by hundreds of dollars from 2017 to 2020, FAIR Health analysis finds

The cost of an average ambulance ride has risen hundreds of dollars in recent years due in large part to advanced life support services that comprise more than half of all private ground ambulance claims, according to a new analysis from FAIR Health.

These services, which provide a higher level of care for greater reimbursement, rose slightly from 2017 to 2020 to represent 51.5% of emergency ground ambulance claim lines by the study’s final year, the healthcare transparency group wrote in a review of its largest-in-the-nation repository of private claims.

Per the analysis, the sticker price for ALS services increased 22.6% from an average charge of $1,042 in 2017 to $1,277 in 2020. However, the average amount private insurers actually paid for those services grew 56% from $486 to $758.

FAIR Health found basic life support (BLS) service charges had also increased during the study period, albeit to a lesser extent. The average charge grew 17.5% from $800 in 2017 to $940 in 2020 while the average allowed amount rose 39.9% from $373 to $522.

Medicare Advantage reimbursement also increased across the study period but at a substantially lower pace. According to the report, the average Medicare amount for ALS services between 2017 and 2020 grew 5% from $441 to $463 as average BLS Medicare payment rose 4.8% from $372 to $390.

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FAIR’s analysis found seniors aged 65 years and older were “consistently” the heaviest users of emergency ground ambulance services, although their slice of the claims dipped from 37.7% in 2016 to 34% in 2020.

Geographically, states in the Northeast and South were the heaviest users of ground ambulances in 2019 and 2020 while the Midwest and Western U.S. were the lowest users—a trend FAIR noted was the opposite of its previous findings regarding fixed-wing air ambulance usage.

In 2020, ground ambulances were driving the furthest on average in Arkansas (27.9 miles), North Dakota (27 miles), Wyoming (24.5 miles), West Virginia (21.6 miles) and Maine (20.9 miles).

Ground ambulances have recently been scrutinized as a contributor to high healthcare costs, particularly due to the exclusion of out-of-network ground ambulance providers from the federal government’s surprise billing law.

That bill did instruct government agencies to begin investigating future policy recommendations related to these services, leading the Biden administration to establish the Ground Ambulance and Patient Billing Advisory Committee back in November. FAIR noted that it conducted its analysis to help inform such policy decisions.