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I get conflicting information when I research this industry. On one end I've read a lot about operators popping up and buying additional helicopters to grow, and on the other end I know hospitals and health care are facing some big challenges in the upcoming future, and could have a tough time staying profitable. It seems that there's a HEMS bubble brewing.


I've also read a lot from recent and past articles about the cost of a transport, and people are questioning if many of the flights were necessary. Will there be a crunch here which reduces flight hours, and reduces the need for some operations?


UAVs are growing, when does this technology replace HEMS pilots?


To the original question, with these thoughts in mind, where do you think the industry will be in 5-10 years, and how do you think it will change?

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Hospitals in general are very profitable, and will continue to be. HEMS is also profitable, and will continue to be. If universal health coverage ever comes around, it will be even more profitable. The cost of HEMS transport is a direct function of lack of insurance, meaning that operators are reimbursed for ~30% of flights. They still make a profit, by charging much more for those who do pay. Like all other medical providers, they give huge discounts to insurance companies.


UAVs will not replace pilots anytime soon. I doubt the med crews will even consider flying an aircraft with no pilot. Nor will patients. Landing a UAV at a scene in the middle of the night, from a van hundreds of miles away, just isn't something anyone wants to contemplate. Kill a few patients and the profit goes away.


I don't think the industry will change fundamentally, but ideally it will get safer. Requiring shorter shifts, and more stable schedules, would go a long way in doing that, but it would require many more pilots. Companies don't like increasing payrolls.

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HEMS reflects the health care industry. If HEMS is on the way out, than you can bet the whole industry is about to collapse. Just like a ground ambulance, it will always be something the industry needs. Fortunately, the helicopter can cut the transport time by a third, sometimes more for mountainous regions. This reduction in transport, plus the fact our crews are providing a higher level of care, will keep HEMS around. I know our company grew by 30 % last year alone.


There was a study done that we only save about 2 % of lives over ground ambulance. With thousands flown every year, that means hundreds are saved. Can't get rid of a service with those numbers. I just flew one (critical) yesterday where I got her to the hospital in 13 minutes (tailwind). It would have taken the ambulance around 35-40 minutes.


In 5-10 years I see HEMS the way it is now, only with more technological upgrades. The optional things that some companies have like TAWS, XM WX, TCAS, NVGs, basic autopilot, etc, will become standard. No way UAVs will take over any time soon. Landing a UAV on a road intersection at night would be a challenge to say the least. Far more other aviation segments (LE, NG, utility) that will see UAVs first. One thing I would like to see in HEMS is a pusher like the S-97 Raider. The ability to land at a scene site then go 250 KTAS to the hospital. That's the perfect HEMS platform.

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What about when all the Vietnam pilots start retiring? :o


Viet Nam Era pilots have been leaving all along. Not many pilots fly beyond 70, and the youngest Viet Nam pilots will be 70 in the next decade, lots of us in the next couple years. A decade sounds like a long time until you consider an ab initio starting right now will take a good part of ten years to qualify for that seat.


Big hospitals are getting bigger, buying smaller existing facilities when possible. In my area, the number of trauma centers are increasing. Ground transport equipment capabilities are improving. These will be tend to shrink HEMS call volume, especially in mature markets.

There's growth potential in remote areas, especially if Obamacare increases insurance coverage, increases compensated flight percentage. That increases competition for traditional community based against the subscription business model.

I don't see increased share of IFR, twins or multi-crew operations.

I think a separate CFR Part is coming for HEMS.

Edited by Wally
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  • 2 weeks later...

We Vietnam-era pilots represent one third of the industry. We range from 60 yrs to 66 yrs of age. I don't think many of us will make it to age 70 as working pilots. Still, the new guys coming in will need to persevere in order to find a place. Tough industry for new guys. Hang in there. Just as hard to get a job in the early 70's (about six pilots applying for every job), and we all did it. You just gotta want it.

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HEMS will always be around. Here is my take. Companies are growing. Helicopters are still being placed all over. There will come a point where we are saturated and this will result in low flight volume. That would lead to the closure of said base.


Some Counties/States require a Certificate of Need. That means the HEMS company needs to show there is a need for a Helicopter in that area. Many locations do not require a CON. As a result you get HEMS bases right next to each other with overlaping service areas. Look at the Phoenix,AZ area. That area recently went through a shuffle of bases and closures as a result of saturation.


When bases of competing companies overlap it becomes important to establish First Call Contracts with hospitals, rotating scene call schedules with Counties. In addition to being willing to think outside the box and really promote customer service for the Hospital, First Responder and the Patient.

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