Ambulance Services for Medicare Beneficiaries: State Differences in Usage, 2012-2014


Improved understanding of how Medicare beneficiaries, most of whom are elderly, use ambulance services provides vital information for policymakers who set rules and regulations about access to ambulance services.

We used data provided by the Centers for Medicare and Medicaid Services, specifically the Medicare Fee-For-Service Provider Utilization and Payment Data: Physician and Other Supplier Public Use File. The file included data for providers that submitted Medicare Part B non-institutional claims during the 2012 through 2014 calendar years. We extracted the list of all providers in each state and the District of Columbia designated as "Ambulance Service Provider."

Ambulance usage differed by state by the following measures: percent of Medicare beneficiaries using services, number of miles transported per year and per day, and number of days of services used in a year. The highest percentage of Medicare beneficiaries using ground ambulance was in New England whereas the least was in the Mountain states. Medicare beneficiaries in the South who used ground ambulance services traveled the most miles in a year and the ones in the West traveled the fewest miles. Air transportation was most prevalent in the West.

Our work took a state-level look at usage across the U.S., the first study to our knowledge to do so. Not all Medicare beneficiaries used ambulance services equally across the states. For instance, two largely rural states, Kentucky and Utah, used ambulance services very differently. We believe policymakers and researchers need to consider differences across the regions of the U.S. when evaluating reimbursement and rules about usage. When looking at changes in the supply of ambulance services in an area, we need to consider the current rate of usage of those services.

Rural and Underserved Health Research Center
SuZanne Troske, Alison Davis