If you need an example of the growth and competition in the medical-helicopter industry, look no further than Fairfield County.
In May, the county with 146,000 residents had no helicopters based there. Now, it has two.
On June 7, Air Evac Lifeteam, the nation's largest medical-helicopter company, opened a base at a Pleasant Township Fire Department station in Lancaster.
Three days later, Columbus-based MedFlight of Ohio set up a temporary base at the county airport, about 5 miles away.
Local officials had long wanted a medical helicopter to serve an area where the population has grown 20 percent in the past decade.
In Fairfield County, emergency medical workers often wait 20 to 30 minutes at crash scenes for a helicopter to arrive to take severely injured patients to Columbus area hospitals.
Now, a helicopter can be there within seven minutes. In trauma care, experts say, every minute counts.
Pleasant Township Fire Chief Jeff Mathias said his firefighters call for a helicopter two or three times a month.
He said he had asked MedFlight in recent years to create a base in Lancaster, but "they said it wasn't feasible. They said there weren't enough flights to warrant it."
So, he started talking to Air Evac last year.
The privately owned company based in Missouri has 101 medical-helicopter bases in 15 states. Five bases are in Ohio.
The company offers memberships to individuals that ensure they won't receive a bill from Air Evac if they're ever transported.
Helicopter companies bill insurance for transports. Patients pay what's not covered.
John Markham, a nurse and field-development manager for Air Evac, said the company locates bases in areas where community leaders request them or the company's research indicates a need.
Since 2007, Air Evac has had four fatal crashes that killed 12 crew members. The company transports about 40,000 patients a year.
Markham said the company works with federal officials after crashes "to learn from it, to make sure it will never happen again."
The company plans to employ 12 to 15 people at the Lancaster base. A lease agreement for space is being worked out with Pleasant Township officials.
To ensure steady business, Air Evac has agreements with Pleasant Township Fire and Fairfield Medical Center that they will call it first to transfer severely injured or critically ill patients to Columbus hospitals.
Mina Ubbing, chief executive of Fairfield Medical Center, said Air Evac approached the hospital about locating a medical helicopter in Lancaster and signing the first-call agreement with the hospital.
"Our perception is, it's 15 minutes closer," she said.
If Air Evac is busy, MedFlight would be called.
MedFlight officials had been watching Air Evac's growth for years and knew they'd eventually compete head-on with the company.
"The competition issues are certainly strong in Ohio now that Air Evac is determined to expand its business," said Rod Crane, chief executive of MedFlight.
He said MedFlight had been considering a move to Lancaster.
"The fact that competition came in certainly motivated us to make that change in a more timely manner," Crane said.
Crane said he's "disappointed" that Fairfield Medical Center signed a first-call agreement with Air Evac, but "we hope to earn their loyalty in the future."
He said MedFlight, which has served Fairfield County for 25 years, moved its Columbus-based helicopter to Lancaster.
That helicopter, and one in Marysville, will cover Franklin County, Crane said.
The air medical industry has had significant growth since Medicare began paying for transporting patients 15 years ago.
In 2005 in Ohio, eight medical companies flew a total of 25 helicopters. Now 16 companies fly 77 helicopters, according to the Ohio Medical Transportation Board.
Nationwide, 900 medical helicopters transport 400,000 patients a year, according to the Association of Air Medical Services.
Fairfield County officials say they are glad that two are in the Lancaster area.
"I think there's going to be plenty (of calls) to go around," said Mike Kiger, a Fairfield County commissioner. "I think it's just going to improve the service to residents of Fairfield County and anyone who travels through Fairfield County."