Utilization of Medicare Ambulance Transports, 2002-2011

WHY WE DID THIS STUDY

Since 2002, Medicare Part B payments for ambulance transports have grown at a faster rate than all Medicare Part B payments. This increase in payments was caused in part by inflation and the transition to the national fee schedule for Medicare ambulance transports. Continued growth in the utilization of transports has also contributed to the increase.

From 2002 to 2011, the number of Medicare ambulance transports increased 69 percent (from 8.7 million to 14.8 million). In 2011, Medicare payments under Part B for ambulance transports totaled $5.7 billion.

HOW WE DID THIS STUDY

We reviewed Medicare Part B claims for ambulance transports from 2002 to 2011 and the Medicare Part A and B claims that were associated with these transports. We also reviewed enrollment data for all Medicare fee-for-service beneficiaries. We determined the extent to which the utilization of ambulance transports changed from 2002 to 2011. For each year, we analyzed the characteristics of beneficiaries, suppliers, and transports and calculated the percentage differences since 2002. We also calculated the changes in utilization within each State.

WHAT WE FOUND

From 2002 to 2011, the number of beneficiaries who received ambulance transports increased 34 percent, although the total number of Medicare fee for service beneficiaries increased just 7 percent. The number of ambulance suppliers increased 26 percent. In particular, the number of ambulance suppliers that primarily provided basic life support nonemergency transports nearly doubled from 2002 to 2011. The number of dialysis related transports increased 269 percent. Furthermore, beneficiaries with end stage renal disease, a condition that often requires dialysis treatment, used a growing and disproportionate amount of transports each year. Transports to and from hospitals increased at a significantly slower rate from 2002 to 2011 than did dialysis related transports, but represented a larger proportion of all transports. Although all States experienced increases in transports from 2002 to 2011, utilization changes varied widely by State.

This report does not contain recommendations.