EMS Markets

Flying Pig · October 16, 2012

So where I am, we have 5 EMS operators. CALSTAR, REACH, two operated by Med-trans and one operated by a local helicopter company that isnt affiliated with any of the major EMS companies. Actually, 6 if you could the Highway Patrol who does EMS. It is a large geographic area, and by that I mean at least an hour to a 1.5 flight away from each other. I dont see a lot of crossover, if any, by the other operators, but Im curious......

How does a company get approval, authority or whatever, to come into a geographical area and set up their operation? If I had the infrastructure and approvals, could I just park my EC135 next to the other guys Bell 407 and be in business? (No, I don't have an EC135 so no PMs about building time please )

When there are multiple operators, how is it determined who gets the call. I have heard that EMS operators "race" to calls and who ever gets there first wins. Is that urban legend or does that happen? Although I dont see them handling calls in our region, I do see them at the airport getting gas, coming and going, etc. I hear them on the radio transitioning the Class C where I know they are a looooooong way from home.

We work pretty closely with our local operator during rescues. There are times we have gone in and retrieved a patient in an area that is out of the scope of the EMS helicopter and brought them out and passed them off because we are NOT an EMS helicopter in the slightest. Unless a bandaid and some anti-bacterial creme is all you needed!

Edited October 16, 2012 by Flying Pig

Wally · October 16, 2012

It varies by state. I've been told that a 135 certificate and an aircraft that met "minimum ambulance requirements" (medical oxygen and air conditioning) and some medical staff, you're rock and roll and in Georgia.

As to who gets the call, I've seen all kinds of patterns: Hospital referral centers to preferred providers, scanner jumpers, old boy networks, medics who remember you did well by the patient on that last call and plain old face time telling agencies that you're available. I know agencies that won't call if the patient has a pulse, some who call for hangnails, but most are driven by real professional concern and judgement. In the end, I don't care whether it's because you're the last unit in the service area or the patient is FTD (fixin' to die), we're here to help, whatever it is- you call, we'll haul. Mdeical directors and insurance can argue about the rest.

Gomer Pylot · October 17, 2012

It's mostly just set up and market. Some states have specific requirements, but mostly all you need is a Part 135 certificate and the proper medical approvals, which vary widely. I don't know of any specific location requirements other than state and FAA approval.

bqmassey · October 17, 2012

I'm interested in learning about this as well. I have a friend with military Medevac experience who thinks he can get the investment capital to start a one-ship, VFR HEMS operation.

Maintenance, I assume, can be outsourced. Can the medical staff be outsourced as well, or would you need a medical director, and RTs/Nurses/Paramedics on your payroll?

I wonder what insurance would cost for something like that.

Flying Pig · October 17, 2012

Wow hed better hope he has fast Mx turn around times with one bird!

Gomer Pylot · October 17, 2012

And deep pockets. The average reimbursement rate is around 30%, which means about 70% of his flights will be for free, no payment, plus all the necessary PR flying will be for free. It takes a long time to develop the rapport necessary to get ground ambulance units and fire departments to start calling you, so he should plan on at least a year with no income at all, and after that it will be slim.

Flying Pig · October 17, 2012

The EMS guys where I am are always flying in for High School "every 15 minute" shows, static displays at public safety fairs and "national night out" events. They were at the last airshow too I believe.

Flying Pig · October 17, 2012

It seems there is a pretty decent amount of "advertising" that involves uncompensated flight time. Even on the small end of the spectrum, whats the DOCs on a 407 fully staffed and equipped? Probably $1000+ per hr for these events?

Gomer Pylot · October 18, 2012

I have no real idea what it costs. I don't pay the bills, I just fly when and where they tell me. But advertising is a major expense for most businesses, regardless of the type of business.

jimbo2181 · October 18, 2012

It's really not that terribly bad. Staff and equipment are being paid for no matter what. All you are paying is a flight hour rate and fuel. Also most hospital run programs utilizing a big corp lease like air methods get so many hours of free pr time so all they are paying for is fuel.

Velocity173 · November 20, 2012

The ground EMS people call the companies that are known for having the hottest flight nurses.

Flying Pig · November 20, 2012

^Im understand you are joking so this isnt a response to yours, however, all the accidents Ive been on, 15 years worth.... I dont know that I have ever heard a request go out for a specific company from the scene. As a Deputy Sheriff, Ive even been the guy a couple of times who has called to get an EMS helicopter started based on the injuries and the remote location of the accident. Ive never asked for a specific company. I just say, "We are going to need to get an EMS helicopter started this way also."

Must be someone in dispatch who decides. Because there are 3 separate ones that could come, to include CHP. However, I have heard EMS peopl and cops generically ask for "Life Flight". There is no "Life Flight" where I am. So the dispatchers just must know who to call.

So I could see the value of making your company a household name!! I am going to start a company and just call it "The Helicopter" Im going to require all of my nurses be attractive females and mandate that they must remove their helmets and interact with the ground troops before they leave the scene. Cha Ching!

Edited November 20, 2012 by Flying Pig

Velocity173 · November 20, 2012

I imagine if a particular company makes a good impression then the ground units could request them??

Edited June 20, 2014 by Velocity173

Gomer Pylot · November 21, 2012

Some EMS companies, and some counties, do call for specific helicopters. We hear it on the scanner all the time. I'm not sure it's ethical, but it certainly happens. Politics is a big player in EMS, just as it is in everything else.