Characteristics and Challenges of Rural Ambulance Agencies – A Brief Review and Policy Considerations


Every year, nearly 10 million rural Americans receive emergency medical services (EMS) care. There are 23,272 ambulance agencies in the U.S., and 73% of those agencies report serving rural areas. Thus, rural Americans rely on EMS professionals to deliver life-saving emergency care every day. Rural Americans expect and deserve an EMS system that is ready and capable of caring for their emergency treatment and transportation needs.

Although EMS is a multifaceted system of care, it is ambulance services, inclusive of emergency care and medical transportation, that comes to mind when most people think of EMS. Yet, many rural ambulance agencies that are fundamental to the EMS system are in jeopardy. Rural ambulance agencies are challenged to deliver timely and high-quality emergency services due to an often-inadequate financing system and an increasing inability to rely on a volunteer workforce. This paper examines current rural ambulance agency characteristics and challenges and identifies public policy considerations designed to stabilize rural ambulance agencies.

RUPRI Health Panel: Rural Policy Analysis and Applications
A. Clinton MacKinney, Keith Mueller, Andrew Coburn, Alana Knudson, Jennifer Lundblad, Timothy McBride