Emergency Medical Services (EMS)

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Chris Kallos

www.zacks.com

Emergency Medical Services Corporation (EMS) is a leading provider of emergency medical services in the United States operating under the AMR and EmCare brands. On January 31, 2005, an investor group led by Onex Partners LP and Onex Corporation purchased both AMR and EmCare from the Laidlaw International Inc. for $828.8M, to form EMS LP, before listing on the NYSE on December 16, 2005. Laidlaw International Inc. had acquired AMR and EmCare in 1997. AMR (American Medical Response) is currently the largest provider of ambulance services in the United States, based on net revenue and number of transports, with an estimated 8% share of the total ambulance services market and a 21% share of the private provider ambulance market. AMR has an operational presence in approximately 34 states. In 4Q05, AMR accounted for 64% of total revenues and 53% of net income. Approximately 60% of AMR's net revenue is currently generated from emergency 911 ambulance transport services. Non-emergency ambulance transport services, including critical care transfer, wheelchair transports and other interfacility transports, account for another 32%, with the balance generated from the provision of training, dispatch centers and other services to communities and public safety agencies. As of September 30, 2005, AMR had approximately 155 contracts with communities and government agencies to provide 911 emergency response services. Contracts with communities to provide emergency transport services are typically exclusive, three to five years in length, and generally are obtained through a competitive bidding process. In addition, AMR had approximately 2,700 contracts to provide non-emergency ambulance services with hospitals, nursing homes and other healthcare facilities that require a stable and reliable source of medical transportation for their patients. At September 30, 2005, AMR had approximately 18,500 employees, including approximately 5,300 paramedics, 7,700 EMTs, 300 nurses and 5,200 support personnel. In 4Q05 EmCare accounted 36% of total revenues and 47% of net income. EmCare is the largest provider of outsourced emergency department staffing and related management services to healthcare facilities with an estimated 6% share of the total emergency department services market and a 9% share of the outsourced emergency department services market. EmCare primarily provides emergency department staffing and related management services to healthcare facilities, including: the recruitment and subsequent subcontracting of physicians and other healthcare professionals, to client hospitals. As of September 30, 2005, EmCare provided services under 333 contracts. EmCare also has practice support agreements with independent physician groups and hospitals for the provision of unbundled management services such as billing and collection, recruiting, risk management and certain other administrative services. In addition, EmCare has become one of the leading providers of hospitalist services. A hospitalist is a physician who specializes in the care of acutely ill patients in an in-patient setting. As of September 30, 2005, EmCare independently contracted with or employed approximately 170 hospitalist physicians. Payment for EmCare services are derived from: the federal and state governments (primarily under the Medicare and Medicaid programs) health maintenance organizations, preferred provider organizations and private insurers hospitals, and individual patients.

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