Understanding the basics of non-emergency medical transportation and who benefits.
What is Non-Emergency Medical Transportation (NEMT)?
Non-Emergency Medical Transportation or NEMT is a phrase typically used to describe a transportation benefit for Medicaid or Medicare members that ensures eligible patients can get to and from their medical appointments, the pharmacy, urgent care, or the hospital. Trips are non-emergency in nature, meaning there is no immediate threat to the health or life of the participant, and no elements of life support are required in the vehicle during the trip. Patients may require NEMT for a variety of reasons, including: lack of a valid driver’s license, lack of a working vehicle, geographic isolation, or the inability to take traditional transportation for physical, mental, or developmental reasons. Non-Emergency Medical Transportation exists to ensure that participants have access to routine and preventative care, increasing overall health outcomes and avoiding costly ambulance bills or emergency room visits. NEMT is especially important for those with chronic conditions such as diabetes, heart disease, cancer, COPD, or asthma.
Who pays for NEMT?
Medicaid NEMT is a $5 billion industry, funded by state and taxpayer dollars, and overseen by the Center for Medicare & Medicaid Services (CMS). Over the past several years, Medicaid spend for NEMT equates to approximately 1% of total Medicaid expenditures, but can impact overall healthcare costs in significant ways. A study by Florida State University found that if just 1% of trips funded result in the avoidance of a hospital stay, the payback to the state is $11.08 for each $1 invested in NEMT. With more than 3.6 million Americans missing or delaying care each year due to transportation issues, the need for effective NEMT is growing each year. Other plans such as Medicare Advantage offer NEMT benefits to members but it is often overlooked.
What does NEMT cover?
NEMT includes a variety of transportation modes, including sedan, wheelchair van, taxis, stretcher cars, and mileage reimbursement. It also may include reimbursement for public transportation or long-distance accommodations such as air travel if a member requires long-distance or out-of-state treatment. NEMT covers all regions from urban to rural, and transportation is always the least costly and most appropriate mode, which is determined on a case-by-case basis for each participant.
Who is Care Connection?
Care Connection is a complete transportation provider, offering a next-generation solution to the logistical challenges of NEMT. We’ve revolutionized NEMT with a technology-first approach that brings the breakthroughs of consumer transportation to the medical industry. Real-time dashboards, supply and demand analytics, and member and provider apps remove the need for traditional dispatch methods and manual trip reporting. Instead of the traditional fixed fleets that have a difficult time scaling when demand is high. Care Connection offers flexible, demand responsive solutions ensuring that every member gets picked up on time. Learn more about how Care Connection is impacting the industry here.