Public Ambulance Agencies and Private Ambulance Agencies – What’s the difference?

Private Ambulance Service Vs Public Ambulance Service

When you’re running a city, you have a lot of things to think about. You have to ensure the safety of your citizens, maintain the budget, and address the concerns of everyone involved. Another area of responsibility is ensuring that the ambulance transportation service you use is ready to respond at all times. And that can be difficult because the Federal government doesn’t deem Emergency Medical Services (EMS) as an essential service, nor do 39 of the 50 states in the U.S., including Texas. That means there is not a generally accepted practice for forming or operating ambulance services, so it’s up to you to decide which type of medical transportation services you will use to best serve your population – a private ambulance service or a public ambulance service. 

Here, we’ll take a look at ambulance transportation and the various types of transportation services you can choose from. 

The Two Types of Emergency Transportation Services

One of your first decisions will be to choose between a private, for-profit operation or a public, not-for-profit organization such as a volunteer, municipal, or hospital-based ambulance company. Each has unique benefits and drawbacks, and you will have to evaluate which model best suits your city or county.

You may be currently using one type of service but are thinking about switching to another. Many cities start out using private ambulance services and later transition to a public, not-for-profit organization.

Let’s take a look at the pros and cons of each one to help you better decide which model is right for you and your citizens.

What Is a Private Ambulance Service?

A private ambulance service is an independent, for-profit, private company contracted by a city or county to  transport patients for a fee. Many times those fees must be subsidized by the municipality to avoid overly high charges for patients. In this scenario, your city or county will pay for the private services offered by the private company, but you will have significantly less input or control over the operations than you would when using a public, non-profit ambulance service.

What’s more, because these types of ambulance companies are profit-oriented, some studies show that they tend to focus on that metric when designing their systems. While these private services still offer all of the medical equipment you would expect to see in an ambulance, sometimes, in an effort to realize a higher profit, the company may offer slower response times, less focus on patient services, and smaller coverage areas. 

Some cities choose private ambulance companies as a supplement to their public municipal or hospital-based ambulance systems. And some have exclusively used private companies but are thinking about making the switch to a public ambulance service.

If your city is thinking about switching to a public model, you should know that the cost of entry can be extremely high with heavy capital expenditures. You will have to invest in the facilities, equipment, vehicles, personnel, and training to get the operation running efficiently.

What Is a Public Ambulance Service?

A public, not-for-profit ambulance service utilizes emergency medical technicians employed by the entity it serves (municipality, hospital, or emergency services district) and offers all types of care such as standard patient care, basic life support, advanced life support, and, if necessary, an air ambulance. These ambulances are available all hours a day and may be combined with the community fire service or fire department. 

Because these public services tend to put patient care above all else, they often lose money so it’s especially important to enlist the help of qualified EMS billing professionals. They will ensure that your agency is reimbursed by Medicare, Medicaid, commercial insurance companies, and other payers to the fullest extent. If you need help with ambulance reimbursements for your city or municipality, we would love to talk with you. Just send us an email at to schedule a free consultation.

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