Helicopter EMS Actuarial Model

This Microsoft Excel workbook (.xlsm) contains the actuarial cost and revenue model supporting the manuscript "An Actuarial Cost and Revenue Model for Helicopter Emergency Medical Services: Estimating Population-Based Coverage and Sustainability Thresholds". The workbook includes seven sheets: README — variable definitions, color coding key, and instructions for replication Inputs — all model parameters (yellow = user-modifiable inputs) Utilization & Revenue — population-based PMPM calculations using Clarivate Real-World Data (Massachusetts, ~3.9M commercially insured lives) Cost Model — itemized fixed and variable cost structure (labor, aircraft, equipment) Breakeven Analysis — deterministic breakeven transport volumes under commercial and Medicare reimbursement scenarios MC Parameters — Monte Carlo simulation distributional assumptions Monte Carlo Results — percentile breakeven distribution and probability-of-viability tables (10,000 iterations via embedded VBA macro) MC Raw Sample (n=2000) — raw simulation draws for independent verification The VBA macro (RunMonteCarlo) can be re-executed to reproduce all simulation results. Reimbursement rates are based on the CMS Ambulance Fee Schedule (CPT codes A0431, A0436) and provider charge data.