No Surprise  

The hospital based are also doing a lot more with less money. Most are twin engine 135/145 with two critical care nurses versus single engine with paramedics. It costs more per transport for them. And yes, there is downstream revenue that flows into the hospital, but there are also many transports that go to a different health system. Bottom line - air methods is feeling the repercussions of becoming way too greedy. They just recently attempted to try to go in network with payors. Too little, too late? 

scary time for air methods pilots/techs.