TEMSA’s Ambulance Survey

The Texas EMS Alliance (TEMSA) conducted a June 2018 survey of Texas EMS agencies regarding which benchmarks they utilize to replace ambulances.

Of the 34 respondents, Medicare classifies them as:

  • Thirteen are “Urban.”
  • Eighteen are “Rural.”
  • Two are “Super Rural.”
  • One was recognized itself as “other.” However, Medicare officially classifies the EMS agency as “Urban.”

Of the ambulance types utilized by the respondents:

  • Twenty utilize Type I.
  • Two utilize Type II. Of these, one is identified by Medicare as Rural and the other is Urban.
  • Eight utilize Type III. Of these, five are Rural and the others are Urban.
  • Four indicated that they utilize a mix of types. Of those four, two are identified by Medicare as Rural and one is Urban. The fourth one is a large EMS agency that represents a mix of urban and rural areas across the state.

Mileage as a Benchmark

The majority of respondents indicated that they rely on mileage, not years, as a benchmark. Of the 34 respondents, four indicated that they rely on years, not miles. However, the vast majority of those that utilize mileage as a benchmark indicated that they also track years, and more commentary on that can be found later.

Of the agencies that use mileage as a benchmark:

One hundred thousand. Three agencies indicated that 100,000 miles was their benchmark for replacement. There are several key notes for this sample:

  • By Medicare classification, one is Urban, one is Rural, and the other is Super Rural.
  • The Super Rural agency indicated that in addition to being 100,000 miles, it must also be nine-years-old. However, it does have exceptions for high maintenance costs.

One hundred fifty thousand. Eight agencies indicated that a mileage range that fell within 150,000 miles served as their benchmark. There are several key notes for this sample:

  • Five out of the eight are classified as “Urban” by CMS. The others are “Rural.”
  • In terms of years, the “150,000 miles benchmark agencies” this typically results in a range of replacement from three to 10 years. The agency on the low end, which is classified as “Rural” by Medicare, indicated that it tries to stay on a three-year rotation.
  • One of the Urban agencies indicated that it rotates an ambulance out of “primary service” at 150,000 miles.

Two hundred thousand. Seven agencies indicated that they had a benchmark of 200,000 miles or more. There are several key notes for this sample:

  • Two were on the lower end at 200,000: one was Urban and the other was Rural. The Urban agency indicated that it judges the condition of the patient compartment, exterior cosmetics, and the maintenance costs.
  • Four indicated that they replace at approximately 250,000 miles.
  • A Rural agency in the Hill Country with seven licensed units was on the high end and indicated that it replaces at approximately 375,000 miles, which equates to every four to five years.

No official policy. Five of the 34 respondents indicated that they did not have an official policy.

Years as a Benchmark

Four agencies indicated that they used years as a benchmark:

  • Medicare classifies two of them as “Urban” and the other two as “Rural.”
  • The two Urban agencies indicated that five years is the benchmark. One was more specific and indicated that this was for Type I ambulances.
  • One Central Texas Rural agency with six licensed units indicated that the front-line units have four years and the reserve units have two years.
  • The other Rural agency, which is located in far North Texas, indicated that it uses seven years as a benchmark.