Non-emergency medical transportation or NEMT is a service that delivers people who lack access to transportation to their necessary but non-emergent medical appointments. These appointments are wide-ranging, but some of the most commonly accessed services include:
- ♦ Dialysis for persons with advanced kidney disease, a service typically needed three times a week
- ♦ Mental and behavioral health appointments
- ♦ Substance abuse counseling and treatment services
- ♦ Primary care or specialist visits
- ♦ Physical therapy or other forms of rehabilitation
NEMT has long been a staple of the Medicaid program for beneficiaries in need of health care services who have no other means of transportation. States have flexibility in designing and implementing their NEMT benefits, including how they are managed to achieve optimal impact at the lowest possible cost.
Many states have turned to specialized transportation brokers that are tasked with managing access to this service for all or part of a state’s Medicaid population. A number of economic studies, including a cost estimate by the Congressional Budget Office (CBO), have found that broker-managed NEMT services help effectively manage costs while preventing fraud and abuse in the program.
In addition to Medicaid beneficiaries, Medicare managed care plans that participate in the Medicare Advantage program are increasingly offering medical transportation benefits to their beneficiaries, recognizing that access to transportation results in improved beneficiary health outcomes and lower costs.
Medicaid covers health care services for low-income Americans, many of whom have chronic diseases and lack access to reliable transportation. Without regular access to health care providers by NEMT, treatable conditions can escalate into more serious and expensive conditions. This results in expensive hospitalizations and nursing home stays that add unnecessary costs to the Medicaid program that access to inexpensive medical transportation could have prevented.
Medicaid health care providers also benefit from NEMT because reliable access to medical transportation means their patients do not miss appointments, stay healthier and do not require more intensive and expensive healthcare services. Federal rules require states to provide no or low-cost NEMT for most Medicaid beneficiaries, but a few states have received waivers to curtail the benefit, and some others are considering doing so. Actions like this have the potential to hurt Medicaid beneficiaries, hurt Medicaid providers and cost taxpayers money in the long-run.
Medicare serves three populations—seniors, disabled, and people with advanced kidney disease—who rely on regular health care services and often face transportation challenges. Medicare’s basic benefits (Part A and Part B) do not include NEMT. But one-third of Medicare beneficiaries elect to receive their benefits through Medicare Advantage (MA) plans.
An increasing number of these plans choose to provide NEMT because it improves health for a modest investment. Additionally, many of Medicare’s new Accountable Care Organizations (ACOs), which organize care in the traditional Medicare program, have opted to provide medical transportation for beneficiaries with certain conditions; providing further recognition that medical transportation helps keep patients healthier. As Medicare continues to innovate, the Department of Health and Human Services can help Medicare beneficiaries stay healthy by making it easier to cover transportation in MA plans, ACOs, and other Medicare health care delivery models.
We currently operate in Washington state, If you are interested in joining our network, please fill out our new vendor application and submit it to our network development team. We will follow up with the next steps.
We appreciate your interest in Empire non-emergency transportations and look forward to speaking with you!