Market Overview
Ambulance Services
- Individuals aged 65 and older make up nearly half of ambulance service users (45.9%), driven by chronic conditions such as heart disease, lung disease, diabetes, and cancer that frequently lead to acute medical episodes. This demographic shift is fueling rising demand for nonemergency ambulance services, which will require greater funding from insurers or private payers.
- As demand grows, large private providers are expected to compete on price, pressuring less efficient public operators and accelerating the trend toward public-private partnerships in the sector. Beyond traditional providers, nonemergency transport is facing new competition from alternatives like Uber Health, Lyft Healthcare, telehealth, and walk-in clinics. These services offer lower-cost, more convenient options for patients who don’t require advanced medical care during transport.
- Over the past three years, more than 25% of emergency department patients during non-peak months waited over four hours for a hospital bed. In winter months, that figure rose to 35%. These strains point to opportunities for EMS innovation, nonemergency transport, and alternative care models.
- Emergency surface ambulances remain the most utilized service at 65% of all U.S. ambulance services, providing rapid transport for patients in acute medical crises. Outfitted with advanced life support equipment and staffed by EMTs or paramedics, they deliver critical care on the way to hospitals.
The U.S. ambulance services market was valued at $21.3 billion in 2024 and is expected to grow at a CAGR of 2.3%, reaching $24.1 billion by 2029.
Mobile Integrated Healthcare Overview
- Mobile Integrated Healthcare (MIH) is a patient-centered model that leverages EMS personnel and other mobile resources to deliver care outside traditional hospital settings. The goal is to improve access, reduce unnecessary emergency department (ED) use, and lower overall healthcare costs.
- An MIH team can be dispatched to a patient’s home to assess their condition. Using telemedicine to consult with a physician, the team may determine that the patient does not need an emergency department visit. This connects directly with Treatment in Place (TIP), a key component of MIH that enables EMS to treat patients on-site rather than defaulting to hospital transport.
- The need for MIH is underscored by the fact that adults aged 65 and older account for nearly 20% of all ER visits. Many of these visits contribute to ED overcrowding despite not requiring inpatient treatment. By diverting such cases through MIH and TIP programs, EMS systems can preserve emergency resources for higher-acuity cases and reduce wait times.
- Policy is also beginning to align with this shift. In April 2025, bipartisan lawmakers reintroduced the Comprehensive Alternative Response for Emergencies (CARE) Act, which would create a five-year pilot payment program testing treatment-in-place under Medicare. This legislation is designed to generate comprehensive data to guide future reimbursement decisions. Medicare beneficiaries account for about 40% of all EMS patients, and an estimated 13% – 16% of Medicare-covered 911 transports involve conditions that do not require hospital-level emergency care.
Treatment in Place (TIP) Claims
- Treatment in Place (TIP) could save Medicare an estimated $1.2 to $1.5 billion each year. It also strengthens EMS by reducing unnecessary transports and helping preserve workforce capacity, all while ensuring patients receive appropriate care in a cost-effective setting.
- Nationwide, about 39% of ambulance TIP claims are reimbursed, averaging $398 per paid claim. Reimbursement for non-ambulance response TIP claims remains limited, but there are still efficiency gains. By reducing the need for additional ambulance dispatches and staff, communities can capture measurable cost savings.
