Global Ambulance Services Industry

  • June 2013
  • -
  • Global Industry Analysts
  • -
  • 320 pages

This report analyzes the worldwide markets for Ambulance Services in US$ Million. The US market is further analyzed by the following Segments: Emergency Services, and Non-Emergency Services.

The report provides separate comprehensive analytics for the US, Canada, Japan, Europe, Australia, and Rest of World.

Annual estimates and forecasts are provided for the period 2010 through 2018. Also, a six-year historic analysis is provided for these markets.

The report profiles 195 companies including many key and niche players such as Acadian Ambulance Service, Inc., AirMed International LLC, Air Methods Corporation, Emergency Medical Services Corporation, American Medical Response, Falck, London Ambulance Service NHS Trust, and Rural/Metro Corporation.

Market data and analytics are derived from primary and secondary research. Company profiles are primarily based on public domain information including company URLs.

Table Of Contents

I. INTRODUCTION, METHODOLOGY and PRODUCT DEFINITIONS
Study Reliability and Reporting Limitations I-1
Disclaimers I-2
Data Interpretation and Reporting Level I-2
Quantitative Techniques and Analytics I-2
Product Definitions and Scope of Study I-3
Ambulance Services I-3
Emergency Services I-3
Non-Emergency Services I-3


II. EXECUTIVE SUMMARY

1. INDUSTRY OVERVIEW II-1
A Prelude II-1
Recession in Retrospect and the Road Ahead II-2

2. MARKET TRENDS, ISSUES AND DRIVERS II-4
Increasing Global Population Offers Significant Growth
Opportunities II-4
Table 1: Top 25 Countries Worldwide in Terms of Population:
2007, 2010 and 2013E II-4
Ageing Population to Boost Demand for Ambulance Services II-5
Table 2: Elderly Population (65+ Years) as a Percentage of
the Total Population: 2000 and 2025 (includes corresponding
Graph/Chart) II-5
Ambulance Services Network Vital for Abating Increasing Road
Fatalities II-7
Table 3: Global Rate of Road Fatalities by Economic Status of
Countries (2013): Percentage Rate of Road Fatalities per
100,000 Residents for Low, Mid and High Per Capita Income
Regions (includes corresponding Graph/Chart) II-8

Table 4: Estimated Number of Annual Road Traffic Mortalities
in Select Countries (2013) (includes corresponding
Graph/Chart) II-9
Telemedicine: A Powerful Tool for Emergency Ambulance Services II-10
Technology Innovations Drives the Ambulance Services Market II-11
Ambulance Vehicles II-11
Ambulance Crew II-12
Emergency Call Operators and Dispatch Services II-12
Air Ambulance Services Fly High II-12
Medical Tourism Industry Boosts Demand for Helicopter
Ambulance Services II-13
Non-Traditional Patients Offer Growth Opportunity for
Ambulance Services II-13
Affordable Care Act: A Boon or Bane for Ambulance Services in
the US? II-14
Impact of Obamacare on Emergency Medical Services and
Ambulance Services II-16
Ambulance Services Market Witnesses Diversified Offerings II-16
Ambulance Subscription Service by Non-Profit Institutions in
the US: A New Safeguard against Insurance Claim Denial II-17
Factors Affecting Performance Levels of Ambulance Services II-18
Challenges Facing Ambulance Services II-19
High Risk Exposure Leads to High Accountability II-19
Dependence on EMS Providers II-19
Reimbursement Issues II-19
Dependence over Existing Agreements II-19

3. AMBULANCE SERVICES - AN INSIGHT II-20
Ambulance Services: Definition II-20
Emergency Ambulance Services II-20
Advanced Life Support (ALS) II-20
Basic Life Support (BLS) II-21
Differences between Basic Life Support (BLS) Ambulance
Services and Advanced Life Support (ALS) Ambulance Services II-21
Non-Emergency Ambulance Services II-21
Air Ambulance Service (AAS) II-22
Major Challenges II-24
Water Ambulance II-24
Service Providers II-24
Ambulance Vehicles: An Overview II-25
Origin and History II-25
Classification of Ambulances by Function II-26
Classification of Ambulances by Vehicle Type II-26
Construction and Design II-27
Equipment II-28
Intermediate Technology II-29
Marking and Appearance II-29
Passive Visual Warnings II-29
Active Visual Warnings II-29
Audible Warnings II-30
Operational Cost II-30
Crew Members of an Ambulance II-30
Military Application II-31

4. PRODUCT INNOVATIONS/LAUNCHES II-32
Air Ambulance America Introduces Medical Flights in Florida II-32
EMS PNG Introduces First Privately-held Ambulance Service in
Capital Port Moresby II-32
Nextant Aerospace Introduces Air Ambulance Conversion Module
for 400XT Model II-32
Government of Egypt Launches River Ambulance Service in Cairo II-32
Malaria Consortium to Unveil Bicycle Ambulance Services II-33
Jet Rescue Launches Learjet 45XR, an Air Ambulance Jet II-33
Atlantic Ambulance Unveils Atlantic Air Three Medevac Chopper
in New Jersey II-34
Executive Jet Middle East Introduces Air Ambulance Services at
Erbil International Airport II-34
Scottish Ambulance Service Purchases Honda Fourth Generation
CR-V First Response Vehicles II-34
The Children’s Air Ambulance Receives Dedicated Air Ambulance
Service Launched for Children II-34
REACH and Methodist Unveils AirCare2 Emergency Helicopter
Services II-35
Angel MedFlight Launches Learjet 60 Air Ambulance Service II-35
Rural/Metro Introduces Emergency Ambulance Services to RETS
Arizona II-35
Heartland Regional Medical Center Introduces New Ambulances II-36
EMSA Launches Pink Ambulances II-36
California Shock Trauma Air Rescue Rolls Out Emergency
Helicopter Service II-36
UNICEF Introduces Mortality Motorbike Ambulances II-36

5. RECENT INDUSTRY ACTIVITY II-37
Falck Takes over Verihealth II-37
Evolution Health Takes Over Guardian Healthcare II-37
GWAS Merges with SWAS II-37
First Call Ambulance Service Acquires EMT II-37
IAG Selects American Care Air Ambulance II-38
AMT and Trinity Regional Health System Partner Introduces
Ambulance Service II-38
GCA Inks Letter of Intent with Waupaca/Weyauwega Area Ambulance II-38
Xtreme Healthcare Acquires Xtreme Care Ambulance II-39
REVA Establishes Regional Headquarters in Arizona II-39
HAEMS Enters into Partnership with Green Lane Ambulance II-39
Falck Secures Contract to Offer Ambulance Services in Sweden II-39
Falck Secures Contract from Carea Hospital II-39
Falck Bags Contract to Offer Ambulances in Germany II-39
Air Methods to Offer Air Ambulance Services in Florida County II-39
Toyota Jamaica Secures Contract from US Health Ministry II-40
AMGH Acquires REACH II-40
Acadian Ambulance Service Takes over StarPlus EMS II-40
Westerkirk and Ironbridge Took Over Demers Ambulances II-40
AMR Inked an Agreement with Aetna II-41
AHS Takes Over Medrium II-41
Falck Takes Over Majority Stake in Grup VL’s Companies II-41
FALCK Acquires Stake in MED1 II-41
Falck Secures Ambulance Contract in Germany II-42
Falck Inks Contract with Sirius Humanum’s Skåne Division II-42
NCMC and Banner Health to Acquire Weld County’s Ambulance Service II-42
Falck Enters into Partnership Agreement with V4 Security Service II-42
Beekman Invests in AAP and Aero Medical II-43
Westhouse Medical Services Divests AST Ambulance Services II-43
Rural/Metro Procures the 911 Contract for Providing Exclusive
Ambulance Services II-43
HALO-Flight Enters into Agreement with Christus Spohn Health
System II-44
North Shore-LIJ Announces Plans to Commence EMS Services II-44
Integrated Services Completes Deal with Rural/Metro II-44
Falck Takes Over American Ambulance Service II-44
PrideSTAR EMS Acquires Health Tech Ambulance Service II-44
Stat/Southcoast EMS Takes over Coastline Ambulance Services II-45
Royal Flying Doctor Service Bags Contract from NSW Air
Ambulance Base II-45
Abbott EMS Secures Contract to Offer Ambulance Services in
Franklin County II-45
Rural/Metro Obtains Contract to Offer Emergency Ambulance
Services in Knox County II-45
Rural/Metro Secures Contract to Offer Emergency Ambulance
Services in Carefree II-46
International Air Medical Services Signs Agreements with
EastBridge II-46
Rural/Metro Extends Operations in Colorado II-46
Rural/Metro Receives Contract to Offer 911 Ambulance Services
in Cass County II-46
Rural/Metro Secures Contract to Offer Emergency Ambulance
Services in Rochester II-46
Veterans Health Administration Selects AMR to Provide Non-
Emergency Ambulance Service II-47
Warburg Pincus Acquires Rural/Metro II-47
EDG Partners Purchases First Call Ambulance Services II-47
Clayton Dubilier and Rice Acquires Emergency Medical Services II-47
Falck Acquires LifeStar II-47
Rolta Acquires ACLS Systems II-48
Air Evac Plans to Operate Helicopter Ambulance Services in
McAllen II-48
West Midlands Ambulance Service Purchases ZOLL E Series® and
AED Pros® II-48
EarthSearch Receives Order for Logiboxxâ„¢ GPS System from
Southeast Ambulance Services II-48
REACH Air Medical Services Announces Merger with Cal-Ore II-49
Aqsaqniq Airways Secures Contract from Nunavut II-49
Rural/Metro Purchases Pacific and Bowers II-50
TriTech Enters into an Agreement to Purchase VisionAIR II-50
Ambitrans Medical Transport Receives License to Operate in
Collier County II-50
Acadian Ambulance Service Takes over NorthStar EMS II-51
Air Methods Takes Over Omniflight Helicopters II-51
Community EMS Forms Joint Venture with Edward Hospital and
Health Services II-51
Cheyenne Regional Medical Center Enters into Partnership with
AirLife II-51
American Medical Response Inks Contract with Boulder County II-52
EMSC Takes Over North Pinellas and Northwood II-52
Rural/Metro Obtains Contract to Offer Ambulance Services in
Sumter County II-52
Southwest Ambulance Secures Contract to Offer Emergency
Ambulance Transport Services in Sun City, Arizona II-52
AMR Obtains Contract to Offer Emergency Ambulance Services in
Manchester II-53
SAAH Inks First Additional Agreement with SAAB II-53
Falck and Tribeca Home Care Fund Purchase Stake in EMI
Holdings Management II-53
EMI Holdings Management Takes Over SER II-53
Falck Receives Contract to Provide Ambulances and Lifeboat in
Lodz Region II-54
Falck Takes Over Krankentransport Herzig II-54

6. FOCUS ON SELECT GLOBAL PLAYERS II-55
Acadian Ambulance Service, Inc. (US) II-55
AirMed International LLC (US) II-55
Air Methods Corporation (US) II-55
Emergency Medical Services Corporation (US) II-56
American Medical Response (US) II-56
Falck (Denmark) II-57
London Ambulance Service NHS Trust (UK) II-57
Rural/Metro Corporation (US) II-58

7. GLOBAL MARKET PERSPECTIVE II-59
Table 5: World Recent Past, Current and Future Market Analysis
for Ambulance Services by Geographic Region/Country - US,
Canada, Japan, Europe, Australia and Rest of World Markets
Independently Analyzed with Annual Revenues in US$ Million for
Years 2010 through 2018 (includes corresponding Graph/Chart) II-59

Table 6: World Historic Review for Ambulance Services by
Geographic Region/Country - US, Canada, Japan, Europe,
Australia and Rest of World Markets Independently Analyzed
with Annual Revenues in US$ Million for Years 2004 through
2009 (includes corresponding Graph/Chart) II-60

Table 7: World 15-Year Perspective for Ambulance Services by
Geographic Region/Country - Percentage Breakdown of Revenues
for US, Canada, Japan, Europe, Australia and Rest of World
Markets for Years 2005, 2013 and 2018 (includes corresponding
Graph/Chart) II-61


III. MARKET

1. THE UNITED STATES III-1
A.Market Analysis III-1
Overview III-1
Table 8: US Ambulance Services Market (2012): Percentage
Breakdown of Revenues by Segment - Government, Private,
Hospital, Public Utility and Others (includes corresponding
Graph/Chart) III-2
Current and Future Analysis III-2
US Ambulance Services Market Witnesses Intensifying Competition III-2
Table 9: Leading Players in the US Ambulance Services
Market (2012): Percentage Breakdown of Revenues for AMR,
Rural/Metro Corp and Others (includes corresponding
Graph/Chart) III-3
Medicare Coverage for Ambulance Services in the US III-3
Affordable Care Act: A Boon or Bane for Ambulance Services
in the US? III-4
Impact of Obamacare on Emergency Medical Services and
Ambulance Services III-5
Ambulance Subscription Service by Non-Profit Institutions in
the US: A New Safeguard against Insurance Claim Denial III-6
An Expanding Outpatient Care Segment: A Solution to Shooting
Healthcare Costs and Rising Incidences of Chronic Diseases III-7
Expansion of Government Health Insurance Schemes: A Cause of
Concern for Rural Ambulance Services? III-8
Other Key Factors Affecting Ambulance Services Market in the US III-8
Emergency Medical Services Industry: A Macro Perspective III-11
Provision of EMS III-11
Private EMS III-12
Private-Public Partnership III-12
Emergency Services III-12
Non-Emergency Services III-13
Competition for Contracts III-13
Operations with Advanced Fleet and Systems III-13
Reimbursement Scenario III-14
Prerequisites III-14
Operational Costs III-14
Standards and Regulations Governing Ambulance Services III-15
Challenges in Rural Markets III-15
Air Ambulance Service: A Crucial Life-Saver III-16
Competitive Scenario in Air Ambulance Services Market III-17
Table 10: Leading Players in the US Air Medical Transport
Market (2012): Percentage Breakdown of Revenues - Air
Methods, AMGH, Petroleum Helicopter, Metro, and Hospitals
and Others (includes corresponding Graph/Chart) III-17
Air Ambulance Helicopters to Equip TAWS Warning System III-17
Recent Product Launches III-18
Strategic Corporate Developments III-21
Key Players III-34
B.Market Analytics III-39
Table 11: The US Recent Past, Current and Future Analysis for
Ambulance Services by Type - Emergency Services and
Non-Emergency Services Markets Independently Analyzed with
Annual Revenue Figures in US$ Million for Years 2010 through
2018 (includes corresponding Graph/Chart) III-39

Table 12: The US Historic Review for Ambulance Services by
Type - Emergency Services and Non-Emergency Services Markets
Independently Analyzed with Annual Revenue Figures in US$
Million for Years 2004 through 2009 (includes corresponding
Graph/Chart) III-40

Table 13: US 15-Year Perspective for Ambulance Services by
Type - Percentage Breakdown of Revenues for Emergency
Services and Non-Emergency Services Markets for 2005, 2013 and
2018 (includes corresponding Graph/Chart) III-41

2. CANADA III-42
A.Market Analysis III-42
Outlook III-42
Strategic Corporate Developments III-42
Stars Air Ambulance - A Key Player III-43
B.Market Analytics III-44
Table 14: Canadian Recent Past, Current and Future Analysis
for Ambulance Services Analyzed with Annual Revenue Figures
in US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-44

Table 15: Canadian Historic Review for Ambulance Services
Analyzed with Annual Revenue Figures in US$ Million for
Years 2004 through 2009 (includes corresponding Graph/Chart) III-45

3. JAPAN III-46
A.Market Analysis III-46
Market Snapshots III-46
Outlook III-46
Growth in Number of Private Service Providers III-46
Facility Shuttle Services III-47
B.Market Analytics III-47
Table 16: Japanese Recent Past, Current and Future Analysis
for Ambulance Services Analyzed with Annual Revenue Figures
in US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-47

Table 17: Japanese Historic Review for Ambulance Services
Analyzed with Annual Revenue Figures in US$ Million for
Years 2004 through 2009 (includes corresponding Graph/Chart) III-48

4. EUROPE III-49
A.Market Analysis III-49
Outlook III-49
Rapid Health Care Response Drives Ambulance Services III-49
An Insight into Ambulance Services across Europe III-49
Privatization: A Potential Threat to Government Run
Ambulance Services III-50
Euro-crisis Impacts Upgrade of Ambulance Services III-50
Technologically Advanced Ambulance Services: A Key to
Success for Healthcare Players III-50
Growing Use of Technology III-51
B.Market Analytics III-52
Table 18: European Recent Past, Current and Future Market
Analysis for Ambulance Services by Geographic Region/Country -
France, Germany, Italy, UK, Spain, Russia and Rest of
Europe Markets Independently Analyzed with Annual Revenue
Figures in US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-52

Table 19: European Historic Review for Ambulance Services by
Geographic Region/Country - France, Germany, Italy, UK,
Spain, Russia and Rest of Europe Markets Independently
Analyzed with Annual Revenue Figures in US$ Million for
Years 2004 through 2009 (includes corresponding Graph/Chart) III-53

Table 20: European 15-Year Perspective for Ambulance
Services by Geographic Region/ Country - Percentage
Breakdown of Revenues for France, Germany, Italy, UK, Spain,
Russia and Rest of Europe Markets for Years 2005, 2013 and
2018 (includes corresponding Graph/Chart) III-54

4a. FRANCE III-55
A.Market Analysis III-55
Overview III-55
B.Market Analytics III-55
Table 21: French Recent Past, Current and Future Analysis for
Ambulance Services Analyzed with Annual Revenue Figures in
US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-55

Table 22: French Historic Review for Ambulance Services
Analyzed with Annual Revenue Figures in US$ Million for
Years 2004 through 2009 (includes corresponding Graph/Chart) III-56

4b. GERMANY III-57
A.Market Analysis III-57
Overview III-57
Strategic Corporate Developments III-57
B.Market Analytics III-58
Table 23: German Recent Past, Current and Future Analysis for
Ambulance Services Analyzed with Annual Revenue Figures in
US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-58

Table 24: German Historic Review for Ambulance Services
Analyzed with Annual Revenue Figures in US$ Million for
Years 2004 through 2009 (includes corresponding Graph/Chart) III-59

4c. ITALY III-60
A.Market Analysis III-60
Outlook III-60
B.Market Analytics III-60
Table 25: Italian Recent Past, Current and Future Analysis for
Ambulance Services Analyzed with Annual Revenue Figures in
US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-60

Table 26: Italian Historic Review for Ambulance Services
Analyzed with Annual Revenue Figures in US$ Million for
Years 2004 through 2009 (includes corresponding Graph/Chart) III-61

4d. THE UNITED KINGDOM III-62
A.Market Analysis III-62
Emergency Ambulance Services in the UK: An Overview III-62
Outlook III-62
Rising Demand for London Ambulance Service III-62
Growing Role of Private Sector III-62
Voluntary Ambulance Service Providers: Growing in Prominence III-63
A Growing Air Ambulance Market III-63
Product Launches III-63
Strategic Corporate Developments III-64
Key Players III-65
B.Market Analytics III-66
Table 27: The UK Recent Past, Current and Future Analysis for
Ambulance Services Analyzed with Annual Revenue Figures in
US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-66

Table 28: The UK Historic Review for Ambulance Services
Analyzed with Annual Revenue Figures in US$ Million for
Years 2004 through 2009 (includes corresponding Graph/Chart) III-67

4e. SPAIN III-68
A.Market Analysis III-68
Outlook III-68
Strategic Corporate Development III-68
B.Market Analytics III-69
Table 29: Spanish Recent Past, Current and Future Analysis for
Ambulance Services Analyzed with Annual Revenue Figures in
US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-69

Table 30: Spanish Historic Review for Ambulance Services
Analyzed with Annual Revenue Figures in US$ Million for
Years 2004 through 2009 (includes corresponding Graph/Chart) III-70

4f. RUSSIA III-71
A.Market Analysis III-71
Outlook III-71
B.Market Analytics III-71
Table 31: Russian Recent Past, Current and Future Analysis for
Ambulance Services Analyzed with Annual Revenue Figures in
US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-71

Table 32: Russian Historic Review for Ambulance Services
Analyzed with Annual Revenue Figures in US$ Million for
Years 2004 through 2009 (includes corresponding Graph/Chart) III-72

4g. REST OF EUROPE III-73
A.Market Analysis III-73
Outlook III-73
Focus on Select Regional Markets III-73
Austria III-73
Bulgaria III-73
Lithuania III-73
Norway III-73
Poland III-74
The Netherlands III-74
Product Introduction/Launch III-74
Strategic Corporate Developments III-75
Falck (Denmark) - Leading Company Worldwide III-76
B.Market Analytics III-77
Table 33: Rest of Europe Recent Past, Current and Future
Analysis for Ambulance Services Analyzed with Annual Revenue
Figures in US$ Million for Years 2010 through 2018 (includes
corresponding Graph/Chart) III-77

Table 34: Rest of Europe Historic Review for Ambulance
Services Analyzed with Annual Revenue Figures in US$ Million
for Years 2004 through 2009 (includes corresponding
Graph/Chart) III-78

5. AUSTRALIA III-79
A.Market Ana

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