ITIC Americas 2025 | Medical transport options across the Americas

The ITIJ team have been reporting live from ITIC Americas in Miami this week (March 2025) sharing the discussions that took place at the conference. Read all reports

Brandon Bates, Senior Director of Global Strategy and Partner Relations, AirMed International

First to speak was Bates, who started his presentation by looking at provider distribution across the Americas. He said that in North America, the density of medical transport providers are concentrated in major metropolitan areas, and that there are seasonal fluctuations in tourist destinations. In Central America there are a smaller number of providers, and South America has “a diverse range of provider density, depending on country”.

Bates then concentrated on operator density and pricing dynamics. He said there were three main things to look at: 

1. Competitive markets – where increased competition can drive down prices, potentially benefiting customers but also impacting service quality
2. Limited competition – areas with fewer providers may experience higher pricing due to reduced competition, posing challenges for cost-sensitive patients and assistance companies
3. Market factors – regulatory environments, infrastructure limitations, and demand fluctuations can influence pricing strategies in medical transport.

Bates said that when it comes market access, air ambulance brokers can streamline the process of securing medical transport by connecting patients and assistance companies with suitable providers. He added that brokers may negotiate pricing on behalf of clients, potentially driving down costs but also creating tension with air medical operators regarding profit margins. He said: “Transparency and ethical practices of air ambulance brokers are subject to scrutiny, with calls for greater regulation to protect patient interests and ensure fair competition.”

Bates said key challenges for air medical operators include maintenance, repair, and overhaul (MRO); staff shortages; and fee increases.

He then talked about operating differences between North and South/Central America. He said that North America generally has more developed infrastructure, facilitating smoother medical transport operations. He added that regulatory frameworks governing medical transport vary across the Americas, influencing operational practices and compliance requirements for providers, and that cultural nuances impact communication, patient expectations, and service delivery in the medical transport process.

Bates talked about the importance of cost containment strategies, and said that proactive and transparent negotiation is imperative; that it’s important to foster collaboration between assistance companies and providers to optimise resource utilisation and improve efficiency; and, when medically appropriate, to utilise ground transport alternatives or commercial medical transport solutions. Investing in technology to streamline operations and reduce costs is vital.

He concluded his presentation by saying it’s imperative to prioritise patient needs and preferences while balancing cost considerations in medical transport solutions; to utilise data analytics to inform strategic decisions and optimise medical transport operations; and to embrace adaptive strategies to navigate evolving market dynamics and regulatory landscapes.

Oliver L Müller, CEO, Gateway International EMS

Next to speak was Müller, who started by saying that in the US it is very common to see long-distance ground transport. Sometimes regional infrastructure can play a role, but this seems to be the exception. More common aspects are flight route limitations.

He then talked about cost considerations, and said the level of service and distance are the main factors when it comes to cost. Regional pricing infrastructure is also an issue. He said that pre-Covid-19 the tendency would be to fly stretcher patients, but this has changed. In South America, he said, the question of airport accessibility in certain regions can be the decider. 

Müller said that in the US there has been an increase of 33% in the last 10 years in ambulance costs. He added that in South America there had not been a significant price increase when going direct, but that in the rare instance where they need to use an agent on the ground, they have seen some price jumping. 

Müller then talked about patient expectations, and said that some expect an air ambulance or commercial flight all the way to their final destination, but some patients prefer ground ambulances due to a fear of flying. Sometimes medical limitations mean a ground transfer is more suitable. He said that some cultures might prioritise flights due to beliefs about health and urgency. Müller added that “routes, geographical and cost considerations all need to be taken into account, but patient expectation and cultural considerations should not be overlooked”. 

He added that effective communication is crucial – the provider should clearly explain the reason for long-distance ground transfer versus flight and that not doing so can lead to disappointment, anxiety and potential customer complaints. 

Müller said there were important things for companies to consider: time (ground ambulances are slower for long distances); comfort (most ground ambulances are not particularly comfortable for long distance); and the fact that most distance ground ambulances are typically provided by specialised services (common in the US, not so much in South America). He said that availability of the actual ambulance company is an issue too. 

Müller concluded by saying there was sustained popularity in long-distance ground transport following the pandemic and that there was a significant increase in the number of cases and quotes. 

Mauricio Cyjon, Chief Executive Officer, SEMM Panamá and Skymedic

Last to speak was Cyjon, who started his presentation by saying that LatAm providers have good intentions, and that there have been infrastructure development, implementation of new technologies and an investment in equipment.

He went on to talk about transport options, and said that choosing the best option for the patient is something that must be studied on a case-by-case basis. Cyjon said that even if there are two cases where the route and the patients’ conditions are the same, there are other factors that must always be considered. 

Cyjon added that for both ground and air transport, “providers are your local thermometer; they are the ones who will give you the key indicators about the service you require. Rely on serious and trustworthy providers who can offer their opinions and alternatives on the best ways to execute the service.”

He said it was important to design a customised transport chain that balances creativity and safety. 

Finally, Cyjon advised on how to find the right provider in LatAm: 

• Don’t wait until you need them to search for them
• Rely on companies dedicated to coordinating these services
• Research their socials and ask for references if possible
• Get to know your provider, even if it’s just virtually
• Look for discrepancies between what they say and what they do.

He noted that it’s vital to always seek a provider who shares the desire to do the best for the patient – that no matter what, the patient is at the heart of all operations.