Average In-Network Amount for Advanced-Life-Support Ground Ambulance Transport Rose 56 Percent from 2017 to 2020

NEW YORK, Feb. 23, 2022 /PRNewswire/ -- The average allowed (in-network) amount for advanced-life-support (ALS) emergency ground ambulance transport (not including mileage fees) rose 56 percent over three years, from $486 in 2017 to $758 in 2020. This was part of a general rise in costs for both ALS and basic-life-support (BLS) emergency ground ambulance transport during this period, including increases in average billed charges and average allowed amounts for privately insured patients.^1,2,3 These are among the findings in FAIR Health's new white paper, Ground Ambulance Services in the United States: A Study of Private Healthcare Claims.

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Charges for ALS emergency ground ambulance services increased from an average of $1,042 in 2017 to $1,277 in 2020—a 22.6 percent increase. The average charge for BLS emergency ground ambulance services increased 17.5 percent from $800 in 2017 to $940 in 2020. The average allowed amount for the same services rose 39.9 percent from $373 to $522 during the same period.

Among the other findings in the report:

• Among patients aged 19-35, mental health conditions were the most common diagnosis associated with emergency ground ambulance in the period 2016-2020.
• Throughout the period 2016-2020, ALS services accounted for a larger percentage of emergency ground ambulance claim lines⁴ than BLS services. For example, in 2020, 51.5 percent of emergency ground ambulance claim lines were associated with ALS compared to 48.5 percent associated with BLS.
• Individuals 65 years and older were consistently the largest age group associated with emergency ground ambulance services, though their share of the distribution decreased from 37.7 percent in 2016 to 34 percent in 2020.
• In the period 2016-2020, females accounted for a larger share of emergency ground ambulance claim lines than males in all but two age groups; males had more claim lines in the 0-18 and 51-64 age groups.
• In the period 2016-2020, the top three reasons patients overall were transported via emergency ground ambulance were (from most to least common) general signs and symptoms, general signs and symptoms involving circulatory and respiratory system, and signs and symptoms involving cognition.
• In 2020, COVID-19 entered the rankings of diagnoses associated with ALS emergency ground ambulance transport at 15th place, and entered the rankings for BLS emergency ground ambulance transport at 10th place.
• In both 2019 and 2020, the five states with the highest emergency ground ambulance use as a percentage of all medical claim lines in that state were all in the Northeast and South, and the five states with the lowest use were in the Midwest and West. According to previously published FAIR Health air ambulance data, this was the opposite of the geographic distribution of fixed-wing air ambulance usage in 2019 and 2020, in which the five states with the highest use were in the Midwest and West and the five states with the lowest use were in the Northeast and South.
• The five states with the highest average mileage for emergency ground ambulance transport in 2020 were Arkansas (27.9 miles), North Dakota (27 miles), Wyoming (24.5 miles), West Virginia (21.6 miles) and Maine (20.9 miles).
• The five states with the lowest average mileage for emergency ground ambulance transport in 2020 were New York (6.9 miles), Alaska (7.5 miles), New Jersey (8.6 miles), Rhode Island (8.9 miles) and Florida (8.9 miles).
• In the period 2016-2020, males had a higher percentage of inpatient admissions after emergency ground ambulance transport than females in all age groups except the youngest—0 to 18 years. In that age group, 35.4 percent of females were admitted to the hospital compared to 32.3 percent of males.

FAIR Health President Robin Gelburd stated: "Ground ambulance services have been the subject of substantial policy interest. We hope that this study of ground ambulance transport proves useful to policy makers, researchers, payors, providers and consumers seeking to better understand this component of the healthcare system."

This report is a companion to a white paper previously issued by FAIR Health on air ambulance services.

For the new white paper, click here.

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About FAIR Health
FAIR Health is a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the federal tax code. It is dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation's largest collection of private healthcare claims data, which includes over 36 billion claim records and is growing at a rate of over 2 billion claim records a year. FAIR Health licenses its privately billed data and data products—including benchmark modules, data visualizations, custom analytics and market indices—to commercial insurers and self-insurers, employers, providers, hospitals and healthcare systems, government agencies, researchers and others. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health includes among the private claims data in its database, data on Medicare Advantage enrollees. FAIR Health can produce insightful analytic reports and data products based on combined Medicare and commercial claims data for government, providers, payors and other authorized users. FAIR Health's systems for processing and storing protected health information have earned HITRUST CSF certification and achieved AICPA SOC 2 compliance by meeting the rigorous data security requirements of these standards. As a testament to the reliability and objectivity of FAIR Health data, the data have been incorporated in statutes and regulations around the country and designated as the official, neutral data source for a variety of state health programs, including workers' compensation and personal injury protection (PIP) programs. FAIR Health data serve as an official reference point in support of certain state balance billing laws that protect consumers against bills for surprise out-of-network and emergency services. FAIR Health also uses its database to power a free consumer website available in English and Spanish, which enables consumers to estimate and plan for their healthcare expenditures and offers a rich educational platform on health insurance. An English/Spanish mobile app offers the same educational platform in a concise format and links to the cost estimation tools. The website has been honored by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality (AHRQ), URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger's Personal Finance. FAIR Health also is named a top resource for patients in Dr. Marty Makary's book The Price We Pay: What Broke American Health Care—and How to Fix It and Dr. Elisabeth Rosenthal's book An American Sickness: How Healthcare Became Big Business and How You Can Take It Back. For more information on FAIR Health, visit fairhealth.org.

Contact:
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FAIR Health
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[email protected]

¹ Costs shown here are for base fees only and do not include mileage fees. Both miles traveled and rates charged or paid per mile can vary widely.
² A charge is the provider's undiscounted fee, which a patient may have to pay when the patient is uninsured, or when the patient chooses to go to a provider who does not belong to the patient's plan's network. An allowed amount is the total fee paid to the provider under an insurance plan. It includes the amount that the health plan pays and the part the patient pays under the plan's in-network cost-sharing provisions (e.g., copay or coinsurance if the patient has met the deductible).
³ ALS services provide a higher level of care than BLS services.
⁴ "Claim lines" are the individual procedures or services listed on an insurance claim.

SOURCE FAIR Health