LifeFlight Maine Pays Paramedics Like Nurses to Curb Staffing Crisis
The nonprofit air ambulance operator implemented pay equity and mental health support after rural hospital closures doubled its flight demand since 2015.
By Amit Ricci ·
Paramedics in Maine’s air medical sector face a stark choice: accept a pay cut to keep costs down or leave for higher salaries. LifeFlight of Maine, a nonprofit operator in Bangor, broke with industry tradition by raising paramedic wages to match those of flight nurses. CEO Joe Kellner, a former paramedic, argues that this pay equity is a necessary cost to retain skilled clinicians in a shrinking workforce. The move aims to stop the bleeding in a sector where nearly a quarter of ground-based workers quit annually.
LifeFlight operates in one of the most rural states in the US, where medical care is often distant. Since 2015, demand for medical flights in Maine has doubled. In 2025, crews completed 3,031 flights, averaging more than one every three hours. This year, demand has risen another 10%. The surge reflects a nationwide trend as rural hospitals close or convert to outpatient facilities, leaving air medical services to fill the gap. The Congressional Budget Office estimates Medicaid cuts of $911 billion over ten years, which threaten hundreds more rural hospitals and maternity departments.
Nicholas George, who runs the ETHOS Database for air medical programs, confirms that the need for these services is increasing year over year. In Maine, the strain is visible. Last year, a woman in a northern town died while dispatchers called 10 ambulance services that did not respond. The state’s fragmented ground EMS system leaves patients at the mercy of air ambulances, which must often fly to remote islands or land in forests to reach patients. Flight nurse Denise Saucier notes that the long stretches without houses or roads remind her how essential the service is.
Recruiting and keeping staff has been a persistent challenge. For years, LifeFlight retained only 60% to 70% of its workers. To address this, Kellner launched the Critical Care Academy, a six to eight month orientation program. The academy uses simulations, including pig tracheas for intubation practice, to prepare clinicians for rare but critical events like emergency births. A mentorship program also recruits new talent. LifeFlight hired its first mentee from last year’s cohort recently.
Mental health support is another key component of the retention strategy. LifeFlight hired a full-time mental-health counselor, a rarity in the industry. Paramedic Brian Merklin, who previously worked in Nevada, cites high burnout rates as a reason for his earlier departure. He notes that crews there worked 96-hour shifts during the pandemic, leading about a third of staff to quit. Merklin now serves on LifeFlight’s peer support team, praising the organization for actually providing the support often promised in other roles.
The financial logic supports the investment. Kellner estimates that training a new clinician costs approximately $100,000. If counseling prevents even a few departures, the program pays for itself. Mike Abernethy, a retired emergency medicine professor, calls LifeFlight a model program, citing its superior aviation and medical quality compared to for-profit competitors. The company’s approach contrasts with the for-profit sector, which often charges high prices to maintain margins.
Today’s flight illustrates the stakes. The helicopter landed on a community hospital rooftop to transport an unconscious patient to a trauma center. Without rapid intervention, the patient faced a high risk of death. Saucier and Merklin worked quickly, stabilized the patient, and prepared for takeoff. As rural hospitals continue to close, the burden on air medical services will likely grow, making the retention of trained staff a critical operational priority.
LifeFlight is not alone in facing these pressures, but it has taken specific steps to mitigate them. The combination of pay parity, rigorous training, and in-house mental health support has allowed the company to reach near-full staffing for the first time in nine years. The strategy relies on the premise that treating clinicians well is cheaper than constantly replacing them. As the healthcare landscape shifts, this model may offer a blueprint for other emergency medical services seeking to sustain their workforce.
