About this episode
Mike Borom, owner of Ambiance Medical Transportation in Los Angeles, bought a company that was 90 percent broker work and walked away from it, exiting wheelchair trips that paid $27 a ride. Brokerage is now about 4 percent of the business and he sells stretcher discharges directly to hospitals, health plans, surgery centers and aftercare centers, running 9 to 15 vehicles a day on trips that average seven miles. The pitch to hospitals is arithmetic: a BLS ambulance bills $400 to $800 for the same non emergency discharge, and up to $1,600 on a weekend.
Key takeaways
- When Ambiance stopped taking broker wheelchair trips, the brokers stopped sending stretcher work too, because gurney trips are what brokers dangle as a reward for covering wheelchair volume.
- Health plans offer roughly $110 for a hospital discharge, and Borom argues no professional stretcher operation survives on that number, least of all one crossing Los Angeles.
- Every attendant at Ambiance is an EMT even though the work does not require it, and Borom sells that credential to hospitals as proof the crew chose healthcare deliberately.
- Medicare audits ambulance billing about every six years, and rejected non emergency trips flow back to the hospital under contract, which is Borom's opening line with discharge planners.
- Alongside the discharge business, the company runs 3,000 subsidized rides a month for California communities in a Lyft partnership where the senior pays 20 percent and the city pays 80.
Chapters
- 0:00 Introduction
- 0:59 Mike's pivot of his NEMT business
- 5:20 Bambi enables operational efficiency
- 9:39 Revenue numbers
- 12:19 Figuring out the business model
- 23:07 The future of Ambiance Medical Transportation
- 25:14 RUN BAMBI RUN!!
