What Tri-State Ambulance does

Tri-State Ambulance, Inc. is a not-for-profit, community-based emergency medical services (EMS) provider founded in 1968 and headquartered in La Crosse, Wisconsin, operating as a subsidiary within the Emplify Health by Gundersen network. The company delivers 911 emergency response, inter-facility medical transport at Basic Life Support (BLS), Advanced Life Support (ALS), and critical care levels, plus specialized neonatal transport in cooperation with Gundersen Air, bike response teams for crowded events, and a non-emergency medical transport service (Coulee Trails). Three operating brands cover distinct geographies: Tri-State Ambulance (southwest Wisconsin and southeast Minnesota, 2,200+ square miles), Gundersen Health System Ambulance (southern Wisconsin and northeast Iowa, ~1,000 square miles, since 2011), and Coulee Trails (Viroqua, WI). Combined coverage spans 8 counties and 3,000+ square miles, staffed by over 100 paramedics and EMTs operating under continuous medical control from Gundersen board-certified emergency physicians.

The business model is service-based, with revenue generated through billing for medically necessary emergency medical services to patients regardless of ability to pay (the company operates without taxpayer subsidy), supplemented by contracted special event medical coverage and published unit-based fees for non-emergency transport (e.g., $22 pick-up, $2.12 loaded mile for Coulee Trails). Distribution is direct: services are accessed through 911 dispatch, hospital/facility transfer requests, and online special event request forms, with no intermediaries or resellers. Technology infrastructure centers on advanced pre-hospital medical equipment (ventilators, cardiac monitors, IV pumps), the PulsePoint community cardiac response app, an electronic patient care reporting (ePCR) system that shares non-transport records with primary care providers (recognized with a 2016 AMBY Award for Innovation in EMS), and online bill payment via PatientNotebook. The organization also operates community health programs including an AED and Hemorrhage Kit Loaner Program (launched 2009), Stop the Bleed training, and Hands-Only CPR education, which collectively have reached 150,000+ event attendees.

Name

Tri-State Ambulance

Legal name

Tri-State Ambulance, Inc.

Website

https://tristateambulance.org

Company type

Private

Founded year

1968

Operating status

Operating

Headcount range

101–250 employees

Short description

Tri-State Ambulance is a not-for-profit, community-based emergency medical services provider founded in 1968 in La Crosse, Wisconsin, delivering 911 response, inter-facility transport, and critical care services across 8 counties in Wisconsin, Minnesota, and Iowa, operating within the Emplify Health by Gundersen network.

Ownership category

akta.pro rank

Product category

Emergency Medical Services

NAICS

Ambulance Services (62191), Special Needs Transportation (485991), Ambulatory Health Care Services (621)

SIC

Services-Misc Health & Allied Services, Nec (8090), Services-Health Services (8000)

akta.pro primary industry

Private EMS Providers (Contract/Interfacility) (HLAFANAB)

akta.pro secondary industries

Critical Care Transport (CCT) & Specialty Transport Teams (HLAFANAE), Interfacility Transport (IFT) & Patient Transfer Services (HLAFANAF), Wheelchair-Accessible Vehicle (WAV) & Stretcher Transport Services (TLAFAKAC)

Keywords

• Emergency medical services
• Ambulance transport
• 911 response
• Inter-facility medical transport
• Critical care transport

Headquarters

HQ city

La Crosse

HQ country

United States

HQ region

North America

Offices8 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Personnel, Operations, Infrastructure, Technology or R&D, Marketing or Sales, Others

Revenue model

1. Emergency Medical Services Billing: Tri-State Ambulance operates as a not-for-profit, charitable, community-based emergency services provider. Revenue is generated through billing for medically necessary emergency medical services to patients, including those with insurance, Medicare, Medicaid, or difficulty paying. Services are provided to all patients regardless of ability to pay.

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels4 records

Core offering

Tri-State Ambulance is a not-for-profit emergency medical services provider delivering 24/7 911 response, inter-facility medical transport up to critical care, and neonatal transport across southwest Wisconsin, southeast Minnesota, and northeast Iowa. The organization also operates Coulee Trails non-emergency medical transport, bike response teams for community events, special event standby coverage, and community education programs including AED and Hemorrhage Kit lending, Hands-Only CPR, and Stop the Bleed training.

Product overview

Tri-State Ambulance operates as a unified emergency medical services organization comprising three primary service lines: Tri-State Ambulance (911 response and inter-facility transport for southwest Wisconsin and southeast Minnesota since 1968), Gundersen Health System Ambulance (911 response for southern Wisconsin and northeast Iowa since 2011), and Coulee Trails (non-emergency medical transport for the Viroqua area). The organization provides a comprehensive spectrum of pre-hospital care ranging from Basic Life Support to Critical Care Transport, including specialized neonatal transports, bike team response for community events, and community health programs including AED lending, CPR training, Stop the Bleed education, and PulsePoint cardiac emergency response integration. Services are available 24/7 with continuous medical control by Gundersen emergency physicians.

Differentiator

Problem solved

Functional benefit

Brands

• Coulee Trails: Non-emergency medical transportation service for elderly and persons who are mentally or physically challenged, serving the Viroqua, WI area.
• Gundersen Health System Ambulance

Products and services

• 911 Emergency Response Primary 24/7 emergency medical dispatch and response service covering more than 2,200 square miles across eight counties in southwest Wisconsin and southeast Minnesota, delivered to residents and visitors via 911 calls.
• Inter-facility Medical Transport Medical transport service for patients between hospitals, clinics, and care facilities at Basic Life Support (BLS) and Advanced Life Support (ALS) levels, including hospital-to-hospital transfers and facility discharges.
• Critical Care Transport Highest level of pre-hospital care delivered by dedicated, specially licensed paramedics and trained EMTs for high-acuity and hemodynamically unstable patients, including a third crew member when patient acuity dictates.
• Neonatal Inter-facility Transport Specialized transport for critically ill newborns delivered in cooperation with Gundersen's Neonatal transport team, using helicopter or ground ambulance equipped with monitoring, environmental, and ventilator support systems.
• Bike Response Team Strategic deployment of paramedics and EMTs on bicycles providing basic and advanced life support at crowded community events such as Riverfest, Oktoberfest, and triathlons.
• Gundersen Health System Ambulance 911 response and inter-facility ambulance services covering approximately 1,000 square miles across southern Wisconsin and northeast Iowa, providing ALS service to Fayette County in Iowa and Crawford County in Wisconsin from stations in West Union, IA and Prairie du Chien, WI.
• Coulee Trails Non-Emergency Medical Transport Non-emergency medical transportation service for elderly and mentally or physically challenged individuals to medical appointments such as dialysis, radiation, and therapy sessions, using handicap-accessible vehicles in the Viroqua, Wisconsin area.
• Special Event Coverage Contracted medical standby and coverage for large community events, festivals, concerts, and sports gatherings, including ambulance showings, educational demonstrations, drill exercises, station tours, and public speaking engagements.
• Education and Training Pre-hospital education and training services including Western Technical College partnership, first responder training, CPR/BLS training, community demonstrations, and child bicycle and helmet safety programs.
• Consulting Services

Quantifiable outcome

• Non-transport patients receiving follow-up care through provider communication, reducing repetitive 911 calls and emergency room visits
• +2 more outcomes

Named customers3 records

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

Feature5 records

Partnerships

Seven partnerships are on record, tiered core and minor.

• Gundersen Health SystemcoreStrategic or Co-development PartnerTri-State Ambulance works in close cooperation with Gundersen Health System, the Coulee Region's premiere medical system. Tri-State operates under Gundersen's medical direction with continuous medical control by Gundersen emergency or specialty physicians. The partnership includes neonate inter-facility transport in cooperation with Gundersen Air helicopter service.
• PulsePointcoreTechnology or IntegrationTri-State Ambulance is partnered with the PulsePoint app, which alerts registered users in the event of a sudden cardiac arrest in a public place within the immediate area and provides the location of nearby automated external defibrillators (AEDs).
• Area Health Systems (Quality Assurance Partners)coreStrategic or Co-development PartnerOn January 1st, 2015, Tri-State Ambulance implemented a new process routing patient records directly to quality assurance nurses at two local health systems for patient follow-up calls and care coordination.
• Partner Ambulance Services (ALS Intercepts)minorStrategic or Co-development PartnerTri-State has intercept arrangements with ambulance services in Caledonia, Houston, Spring Grove, Rushford, New Albin, Lansing, and Soldier's Grove to bring higher level of care (ALS) to patients during transports.
• American Ambulance AssociationminorOthersTri-State Ambulance is a member of the American Ambulance Association, which represents hundreds of ambulance services across the United States and serves as a voice and clearinghouse for ambulance services.
• Wisconsin EMS Association (WEMSA)minorOthersTri-State Ambulance is a member of the Wisconsin EMS Association, which promotes excellence and quality in the ambulance industry in Wisconsin.
• Professional Ambulance Association of Wisconsin (PAAW)minorOthersTri-State Ambulance is a member of PAAW, created in 2005 to represent the interests of ambulance services in Wisconsin and promote excellence and quality in the ambulance industry.

Scale indicators9 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Priority Ambulance: Private EMS company operating across multiple states with 911 contracts, interfacility transport, and critical care services. Comparable for-profit private EMS peer with multi-state growth strategy emphasizing contract wins in suburban and ex-urban markets.
• Gold Cross Ambulance: Private EMS provider serving western Wisconsin, Minnesota, and Iowa with 911 response and interfacility transport. Direct geographic peer to Tri-State in the upper Midwest with overlapping tri-state service territory.
• Bell Ambulance: Private, family-owned ambulance service based in Milwaukee, Wisconsin, providing 911 response, ALS, critical care, and special event coverage. Direct regional peer in Wisconsin with comparable service mix and rural/urban Wisconsin presence.
• Mecklenburg EMS Agency (MEDIC): Public-private partnership EMS agency providing 911 response and interfacility transport in the Charlotte, NC metro area. Comparable in offering integrated community EMS with full-acuity spectrum analogous to Tri-State's multi-service-line model.
• Acadian Ambulance Service: Large private EMS provider offering 911 response, interfacility transport, critical care, and air medical services across Louisiana, Texas, Mississippi, and Tennessee. Highly comparable to Tri-State given the multi-state service area and full spectrum of ground EMS, critical care, and air medical partnerships with health systems.
• Mayo Clinic Ambulance: Hospital-system-affiliated ambulance service operated by Mayo Clinic Health System serving southeast Minnesota and northern Iowa. Highly analogous model—health-system-owned non-profit EMS providing 911 response, ALS, and critical care transport within a rural upper-Midwest service area.
• MMT Ambulance (Paratech Ambulance): Mid-size private EMS provider offering 911 response and interfacility transport across multiple U.S. regions. Analogous to Tri-State in size and operational scale, with comparable full-acuity service offerings.

Broad incumbents

• Falck USA: Global EMS provider with U.S. operations providing 911, interfacility, and critical care services. Comparable private/international EMS operator with broad service-line breadth and contract-based municipal relationships.
• American Medical Response (AMR): The largest private ambulance and EMS provider in the United States, owned by Global Medical Response. AMR is the closest comparable private 911 and interfacility peer, operating across hundreds of municipalities and serving as a benchmark for private, contract-based EMS operations like Tri-State.

Others

• PulsePoint Foundation: Non-profit technology partner that supplies the cardiac-arrest alerting app integrated with Tri-State's community response program. Listed as an ecosystem/adjacent technology peer rather than a direct competitor.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/tristateamb
• Facebookfacebook.com/tristateamb
• LinkedInlinkedin.com/company/tri-stateambulance

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles14 records

Subsidiaries2 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Tri-State Ambulance