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