Emergency Ground Ambulance Costs: Trends and Policy Implications
Charges for both in- and out-of-network emergency ground ambulance services have risen by 30 percent above medical inflation since 2012. Using data from Elevance Health-affiliated commercial health plans, this study evaluated trends in costs of emergency ground ambulance services in 2012-2025.
The No Surprises Act, a law which protects patients nationally from surprise billing, does not cover ground ambulances due to the complicated nature of providing these services. Instead, many states have passed or are working to pass laws to protect patients from surprise bills from ground ambulance rides.
This study found that in-network allowed costs for emergency ground ambulance services averaged between 100 and 250 percent of Medicare prices in most states, with a national average of 161 percent. As states work toward protecting patients from out-of-network balance bills for emergency ground ambulance services, they may look to in-network allowed cost benchmarks when determining fair reimbursement for ground ambulance services.
Related Public Policy Research
The No Surprises Act: Independent Dispute Resolution for Planned Procedures
This study found that provider payments from the No Surprises Act’s Independent Dispute Resolution (IDR) process for certain planned out-of-network procedures far exceeded in-network commercial and Medicare benchmarks. Policy changes are needed to align IDR outcomes with the law’s original intent and prevent excess costs.
Arbitration Outcomes for Out-of-Network Medical Bills Under the No Surprises Act
This study, published in INQUIRY: The Journal of Health Care Organization, Provision, and Financing, compared final payments for out-of-network care from disputes that underwent arbitration under the No Surprises Act in 2023 to commercial in-network rates and Medicare rates.
Estimating Surprise Bills Among Members of Commercial Health Insurance
Potential surprise bills occurred for 1.8 percent of members and 6.2 percent of episodes in 2018. Emergency episodes had a higher rate of potential surprise bills than non-emergency care.