Are you about starting an air medical transport company? If YES, here are 22 best air medical transport companies you can study and a competitive analysis.

Air medical transportation also known as Air ambulances are used to quickly move patients in life-threatening situations. These transports are usually helicopters equipped with medical equipment and staffed by medical professionals just like traditional ground ambulances.

Reports have it that over 550,000 patients in the U.S. use air transport or air ambulance services every year. Air transportation or ambulance services have risen significantly over the years.

Possible reasons for the growth of this industry include an aging population, a decline in the number of emergency departments in existing hospitals, and changes in the delivery of health care in rural settings. There are also concerns that such high growth in this industry may be an indicator of medically unnecessary use.

Meanwhile, the cost for the average air medical trip run in the tens-of-thousands of dollars. These high costs can be attributed to maintenance of expensive equipment as well as the need to have specialized medical personnel around-the-clock.

Have it in mind that air medical transportation are mostly covered by health insurance in certain types of emergencies or if a doctor certifies that air transport is medically necessary, and if a patient is going to the nearest appropriate facility.

But, if the transport is done for mere convenience, such as to relocate nearer to family, it might not be covered. For patients with health insurance, out-of-pocket costs typically consist of a copay of less than $50 to $500 or more, or coinsurance of 10 % to 50% or more for a total that could reach the yearly out-of-pocket maximum.

While for patients without health insurance, the cost of air trips or ambulance service typically depends on: the current cost of jet fuel, the type of aircraft used, the distance flown and the type of medical staff required. The total can be less than $2,000 for a short flight to almost $50,000 for a longer domestic flight to $200,000 or more for an international flight.

An air medical transportation service, when necessary, includes a pre-flight medical evaluation and consultation with the patient’s physician to determine the equipment and care needed during the flight.

The flight typically takes place on a helicopter, a propeller plane, or a jet that is equipped with a flight stretcher and advanced life-support equipment, including oxygen, a ventilator, monitors, a defibrillator, IV equipment and other medical supplies. At least one family member may accompany the patient at no extra charge.

Booking an air ambulance flight through a broker can add hundreds or thousands of dollars to the final cost due to commissions paid to the broker. Also note that some air medical transportation companies offer discounts to patients who are flexible; most commonly, if one patient is flying from one city to another, and another is flying back to the city of origin, both patients can be offered discounts of 30% or more.

For fairly stable patients, a specially trained medical escort, usually a paramedic or nurse, can accompany the patient on a commercial flight for a fraction of the cost of an air ambulance.

Some of the top companies in this industry are privately held, making financial data scarce. The only statistic that is usually available is the number of aircraft per provider, although this figure is always debatable. But, below are top air medical transportation companies in the US.

22 Best Air Medical Transport Companies and Their Charges

  1. EastCare

Vidant EastCare is better known as the critical care mobile air and ground transport of Vidant Health (VH) at Vidant Medical Center (VMC). This air medical transportation company serves 31 counties in Eastern North Carolina. Sponsored by VMC and The Brody School of Medicine at East Carolina University, VMC is the only level 1 trauma center east of Raleigh.

It is one of nine air ambulances plus Marine Corps Air Station Cherry Point, located in North Carolina, and serves a radius  of 230 nautical miles (430 km; 260 mi) around Greenville without refueling. Vidant EastCare can be dispatched for a number of causes, including: trauma, burn, neonatal, high risk pregnancy, hyperbaric medicine, stroke and myocardial infarction.

Vidant EastCare currently has six helicopters with bases in Beaufort County, Nash County, Craven County, Wayne County, and Onslow County. Metro Aviation, Inc., based in Shreveport, LA. is the aviation operator. The helicopters complete around 3,500 transports per year, with the average one-way flight being 45 minutes.

  1. Air Methods

Air Methods fleet includes 306 helicopters, down slightly from the 314 listed Dec. 31, 2009. One of the few publicly held companies in the industry, the operator employs 957 line pilots—fixed- and rotary-wing—493 mechanics and 765 flight nurses and paramedics.

The company flew a total of 129,143 flight hours in 2009, 82,582 through August 2010. This air ambulance company transports about 100,000 patients a year. Gross revenues in 2009 totaled $511 million with a net income of $29 million.

Air Methods is known to combine community-based and hospital-based services in its CBS and HBS divisions, with 31 of the former and 56 of the latter, defined by traditional hospital contracts. Also, it currently has 113 community bases and 125 hospital bases, with one aircraft at each base.

The remaining 68 helicopters include spares as well as new aircraft not yet deployed in the field, training aircraft and aircraft for sale. About 15 percent of the fleet is owned by hospital customers. The two divisions operate collectively in about 45 states.

Besides its field mechanics at the base level, Air Methods has five depot-level facilities and a completion center in Denver that also serves military and commercial customers. Of the company’s 306 helicopters, 195 are NVG-equipped, 130 are HTAWS-equipped, 156 have XM satellite weather, 289 have GPS navigation, 279 have satellite tracking and 189 have wire-cutting apparatus.

Air Medical Group Holdings (AMGH), a holding company which has just announced a major recapitalization program, has three HEMS subsidiaries operating some 165 helicopters. Air Methods, in a recently updated presentation, shows AMGH as second in revenues, with an estimated $350 million for the year ending June 30, 2010.

  1. AC Global Medical Transports

This company is owned and operated by Milan and Joan Floribus. Milan has been involved in the air ambulance and medical evacuation industry since 1981 and is widely known and respected across the world. His wife, Joan, has been in the industry since 2006, and provides the highest quality patient care and medical evacuations via air ambulance.

All AC Global aircraft providers have received the highest rating offered by ARG/US, and has been deemed a ARG/US Platinum Rated Operator. This level of safety rating is only awarded to those operators who have met the criteria for the lower ratings of Silver and Gold, as well as successfully passing an on-site safety audit conducted by ARG/US itself.

  1. Air Evac Lifeteam

Air Evac Lifeteam (Air Evac), fields a fleet of 110 Bell helicopters. Air Evac estimates it will fly about 62,000 flight hours in 2019. The company operates 93 bases in 14 states, with one aircraft at each base. The 17 remaining helicopters are used in training, for backup or are undergoing refurbishment.

Air Evac employs 367 pilots, 215 mechanics, 358 nurses and 345 paramedics. Air Evac is also a Part 145 repair station, Bell factory service center and FAA completion center.

Air Evac is 100 percent community-based and is considered to be one program in terms of EMS licensure and management. Air Evac also is the largest operator that is already 100 percent NVG-equipped and operational. The fleet is 100 percent satellite-tracked. Air Evac’s membership program has more than 800,000 participants, according to its website.

The program allows individuals, for $50 a year, and entire households, for $60 a year, to know that if they are flown by Air Evac during that period, the operator will accept whatever the patient’s insurer or Medicare provides as payment in full, without asking patients to pay anything that an insurance company may deny.

  1. Flight For Life

Renowned as a prehospital care service with a handful of bases of operational across the united states, Flight for Life is majorly known for its emergency medical helicopter transport, but also operates a fleet of land vehicles and fixed-wing aircraft for the transport of critically ill patients. Helicopter transport is normally reserved for the most critically injured patients or patients who cannot be reached by traditional means of Emergency medical services.

  1. CareFlight

This program serves over 150 hospitals and over 300 community fire departments, and police departments in 17 counties. Right from its inception on October 6, 1983, CareFlight has made over 25,000 flights. In addition to three Eurocopter Dauphin helicopters, CareFlight includes six ambulances, called Mobile Intensive Care Units (MICUs) for ground transport.

The MICUs(mobile intensive care unit) cover a 75-mile (121 km) radius from MVH, and CareFlight air ambulances serve a 150-mile (240 km) radius. This includes most of Ohio  and parts of West Virginia, Michigan, Kentucky, and Indiana.

  1. Omniflight

Omniflight fields 90 helicopters, including 14 customer-owned or -leased aircraft. The largest component averages less than 10 years old. For a payment of $49 a year per household, members can be sure that if they need Omniflight air medical transport, the company will not ask them to pay any part of the bill.

More than 200 people signed up on the OmniAdvantage website before the program was launched. The company operates in 19 states with 72 bases—44 community-based and 28 hospital-based.

The operator employs about 290 helicopter pilots. At the beginning of 2010 Omniflight began to outsource heavy maintenance to Heli-One. Omniflight has regional communication centers and a centralized command center at its headquarters. Among other differentiators, Omniflight cites customization of its aircraft offering to the needs of local environments.

  1. Acadian Ambulance

Acadian Ambulance is an employee-owner private ambulance service that covers most of the state of Louisiana, a large portion of Texas, and one county in Mississippi and Tennessee. Acadian Ambulance operates a fleet of more than 400 ground ambulances, as well as eight medical transport helicopters and five fixed-wing aircraft that provide aerial transport to medical facilities.

In addition to emergency medical services, Acadian provides an aircraft charter service, a personal medical alarm service, fire and burglar alarm service, industrial medical personnel, fire and safety technicians, medical and industrial training, as well as billing software.

  1. PHI Air Medical

PHI Air Medical (phiairmedical.com) is the business unit of publicly held PHI Inc. Although this air medical transport provider is not an independent operator, PHI Air Medical’s 82 air ambulance helicopters make them a key player in the industry.

Of these, three are customer-owned and the balance are PHI-owned. About 75 percent of the helicopters are 2003 or newer models. Average aircraft uptime is 98 percent but average base-in-service is better than 98 percent. There are about nine backup aircraft. The unit expects to transport about 30,000 patients each year. The unit has 290 pilots, 101 mechanics and 550 medical crew members serving 70 bases. It operates in 18 states.

The air medical helicopters are all NVG-equipped and satellite tracked. PHI mandates all pilots of VFR aircraft to attend additional flight training at six-month intervals and that the second round of training—in the aircraft or a simulator—focuses on the management of inadvertent IMC. Simulation training is extensive, but PHI also requires pilots of single-engine aircraft to conduct autorotation to the ground in the actual aircraft.

  1. CALSTAR

CALSTAR (California Shock Trauma Air Rescue) is a 501(c)(3) nonprofit regional air medical services company covering California and northern Nevada. This company is currently the largest nonprofit air ambulance provider on the West Coast.

CALSTAR’s operations had grown to ten helicopter EMS bases located throughout Northern and Central California and a fixed wing program providing inter-facility transport services from the company’s headquarters at McClellan Park (formerly McClellan Air Force Base) in Sacrament, California.

Right from its inception, CALSTAR has provided air medical transport services to more than 50,000 critically ill and injured patients, and has logged over 75,000 accident-free flight hours. For over 30 years, CALSTAR has been an invaluable addition to California’s emergency medical response services.

Each CALSTAR flight crew is staffed with two registered nurses. CALSTAR flight nurses must achieve and maintain Certified Flight Registered Nurse (CFRN), Critical Care Registered Nurse (CCRN), Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) certifications

  1. Metro Life Flight

Metro Life Flight serves the Cleveland, Ohio area, and is part of the MetroHealth system. The system is fully CAMTS certified, and provides transport between local hospitals, as well as emergency transport to MetroHealth Medical Center, a Level 1 Trauma Center.

It was established in 1982 as the first air medical program in Northeast Ohio. In 1984 the service switched a dual pilot system. In 2009, the main operating base was moved from MetroHealth Medical Center to three bases in the surrounding area.

  1. Metro Aviation

Metro Aviation boasts of 62 helicopters, 55 of which are twins. Unlike its competitors, Metro is a sole proprietorship. Of its 62 ships, 60 percent are hospital-owned and 40 percent Metro-owned or -leased. Fifteen of the 62 are dedicated backup helicopters—four IFR and 11 VFR. Metro averages 32,000 to 33,000 flight hours a year and about 35,000 to 36,000 operations a year.

It expects to transport at least 27,000 patients every year. It has 49 bases in 15 states plus the District of Columbia. Report cites an approximately 98.6 percent aircraft availability number, attributing that to the depth of Metro’s spare parts inventory and number of backup aircraft. Metro carries about $200,000-worth of inventory per operational helicopter.

  1. AirMed

AirMed International, LLC, based in Birmingham, Alabama, is a fee for service air ambulance. AirMed was established in 1987 as MEDjet International and renamed AirMed International in 2003. AirMed offers international service to all countries except for Iraq, North Korea, and Libya. AirMed is also a contracted carrier for the U.S. Department of Defense.

AirMed holds accreditation from the Commission on Accreditation of Medical Transport Systems (CAMTS) and the European Aero-medical Institute. AirMed is also a dedicated member of the Association of Air Medical Services (AAMS), and created an air ambulance industry website, weatherturndown.com, allowing medical transport programs to share current information regarding delays or cancellations due to weather or other hazards.

AirMed also offers a pre-paid air ambulance membership for individuals and families known as AirMed Traveler. Blue Cross and Blue Shield of Alabama includes air medical benefits through AirMed for its members. In 2011, AirMed International was named Official Air Ambulance of INDYCAR, the Izod IndyCar Series and Firestone Indy Lights.

  1. Med-Trans

Med-Trans has 43 helicopters, averaging about four years old, and no fixed-wing aircraft. The operator employs hybrid versions of both the hospital-based and community-based business models. Med-Trans employs about 160 pilots. It has founded 35 bases in about 16 states and expects to transport more than 15,000 patients every year.

The company prides itself on its safety equipment. It was the first HEMS operator to reach 100 percent NVG equipage. Note that about 70 percent of the fleet is equipped with HTAWS and all aircraft are satellite-tracked. Med-Trans also provides quarterly training to all its pilots.

  1. MedFlight

MedFlight is better known as a non-profit, CAMTS – accredited critical care transport organization. MedFlight’s headquarters is in Columbus, Ohio at the Ohio State University Airport (Don Scott Field) with nine helicopter bases and 3 Mobile ICU ground teams. Helicopter Aviation services are contracted to MedFlight through Metro Aviation, Inc.

  1. EraMED

EraMED is owned by publicly traded Seacor Holdings. It has a fleet of about 29 helicopters and is entirely hospital-based. EraMED is merging with its sister company, Era Helicopters, and will be a focused line of business. The merger is expected to finish by the end of the year.

The company has 15 HEMS bases and operates air medical services in six states. It employs more than 70 HEMS pilots, 28 mechanics and no medical personnel. It services six programs and anticipates more than 12,000 HEMS flight hours in 2010.

  1. American Medical Response

American Medical Response, Inc. (AMR) is a medical transportation company in the United States that provides and manages community-based medical transportation services, including emergency (911), non-emergency and managed transportation, fixed-wing air ambulance and disaster response.

AMR employs more than 28,000 clinicians and has a fleet of more than 6,600 ambulances, as well as air ambulances and contracted vehicles that transport people living in more than 4,000 communities nationwide and internationally.

  1. Mercy Flights

Mercy Flights was established as a non-profit organization in 1949 by Bill brooks now living in Alaska, and George Milligan, an air traffic controller in Medford, after a friend of his died of polio in Southern Oregon, unable to survive the long, slow ground transport to Portland.

A membership program was founded which provided people in the community an opportunity to contribute to Mercy Flights, while making sure that they would be financially covered in the event that they needed air medical transportation. To date, Mercy Flights has flown more than 15,000 patients throughout the western United States.

Mercy Flights’ ground ambulance service currently serves more than 18,000 patients each year. Mercy Flights currently has two pressurized King Air C-90s. These powerful twin-engine turboprop airplanes are pressurized up to 30,000 feet.

  1. STAT MedEvac

STAT MedEvac is a service of the Center for Emergency Medicine of Western Pennsylvania, an independent, non-profit entity directed by a consortium of University of Pittsburgh Medical Center hospitals. STAT MedEvac operates 21 twin-engine helicopters.

Seven helicopters are owned by STAT MedEvac and the rest are leased. Its uptime rate is 98 percent. It also employs 12 flight followers at its Pittsburgh communications center. The Center for Emergency Medicine, which holds the operator’s Part 135 certificate, provides STAT MedEvac’s 75 pilots, 31 mechanics, 110 nurses and 90 paramedics. STAT MedEvac flew 9,666 patient flights and a total of 12,536 flight hours in 2009.

  1. CareFlite

CareFlite is a nonprofit ambulance service based in Grand Prairie, Texas, which operates throughout North Texas. CareFlite’s original namesake service is helicopter air ambulance, though today it also performs fixed-wing and ground transport.

This company began operations in 1979. It originated with one helicopter, a Bell 206L, which was shared between Methodist Dallas Medical Center and Harris Methodist Fort Worth Hospital. CareFlite augmented their air ambulance service with ground operations in 1981.

As with some other air ambulance services, CareFlite offers yearly memberships to cover transport costs not paid by medical insurance. The membership costs are charged per household. This includes helicopter, ground, and most fixed-wing transport costs.

  1. ARCH Air Medical Service

This company offers critical care air ambulance service in Missouri, Illinois, and surrounding regions. Air ambulance programs (also known as Medevac) offer transport by helicopter (rotor-wing) or fixed-wing aircraft. ARCH Air was the twelfth program in the U.S. to offer such services when it began operating in March 1979.

This company transports approximately 4,200 patients per year by rotor wing, ARCH aircraft are staffed with a pilot, nurse and paramedic. Flights are 80% inter-facility (hospital to hospital) and 20% scene.

Transport is also provided for specialty teams from St Mary’s Health Center obstetrics, Cardinal Glennon Children’s Hospital, St. John’s Mercy Medical Center, Creve Coeur neonatal, St. Francis Medical Center, Cape Girardeau neonatal, Southeast Missouri Hospital Cape Girardeau neonatal, and St. John’s Hospital, Springfield, IL neonatal, University of Missouri Children’s Transport Service Peds and Neonate.

  1. Boston MedFlight

Boston MedFlight (BMF) is a non-profit organization that offers emergency scene response and emergency interfacility transfer in Eastern Massachusetts at the Critical Care level, which is higher than a paramedic-level ambulance crew’s certification, using both aircraft and ground ambulances.

BMF nurses hold multiple other certifications such as Certified Flight Registered Nurse (CFRN) (within one year of hire if not already certified), Critical Care Registered Nurse (CCRN) and/or Certified Emergency Nurse (CEN).

BMF Transport Specialists (paramedics) similarly become Certified Flight Paramedics  within one year of hire if they do not already hold FP-C certification. This company also staffs and operates its own communications center at the Bedford headquarters.

Communications Specialists are required to be Nationally Registered EMTs, or the Massachusetts equivalent; they are also expected to complete an International Association of Medical Transport Communications Specialists Certified Flight Communicator course within their first year, course schedule permitting. All their helicopter (rotary wing) and airplane (fixed wing) pilots are rated at the Airline Transport Pilot level, the highest level of pilot license.