The current state of NEMT

For many of us, a ride to the doctor isn’t a major dilemma that we face on a regular basis.But for an estimated 3.6 Americans that miss or arrive late to routine non-emergency]’appointments, this is their reality. The ramifications for these missed appointments are not only detrimental to the patient’s health, but they cost the health industry an extra $150 billion each year.
These overwhelming statistics are the root of controversy surrounding Non-Emergency Medical Transportation (NEMT) in the U.S. There is some good news however. NEMT awareness has skyrocketed in recent years and there are many institutions prepared to help save the future of NEMT.

Why is NEMT crucial to the medical ecosystem?

NEMT services are intended to transport patients to and from medical appointments and other non-emergent care. NEMT transportation modes include sedan, wheelchair van, taxis, mileage reimbursement and in some cases long distance accommodations if an out of state specialist is required. The recipients of this service are healthcare consumers that face travel obstacles when attending medical appointments. Common obstacles include lack of family support and unstable financial situations.
Patients with chronic conditions such as asthma, cancer and diabetes rely heavily on NEMT services in order to attend frequent check ups.  Missed appointments by this population of patients could mean life or death. Missed medical appointments reduce patient adherence with clinical guidelines, which leads to complications and the need for more expensive medical services.

NEMT is a lifeline for Medicaid recipients

Medicaid is most commonly associated with NEMT services. Since 1965 when Medicaid was signed into law, congress has required states to provide transportation for beneficiaries. The original Handbook of Public Assistance affirms, “states are required to offer families necessary assistance with transportation to and from providers.” Individual states were also given the opportunity to choose how their transportation programs were managed. Hence the conception of various NEMT models including government entities and private brokers.

Exploring the issues with NEMT programs

There have been endless reports across the U.S. of drivers not arriving on time or at all with no notice. In addition to no call no shows, patients have reported that their rides have been cancelled at the last minute due to their driver not having access to wheelchair accessible vehicles. Last month, Veyo, a NEMT fleet provider, was sued and accused of acts including late driver arrivals, poor customer service and inadequate wheelchair accessible services.
In addition to logistical issues, there have been claims of harassment from NEMT drivers.  A New Jersey NEMT survey elicited feedback from patients stating that they “feared for their safety during transit”, or  suffered harassment and disrespect. Unfortunately, the payout for NEMT services is so low in some markets, states are forced to work with providers that lack experience and the wherewithal to manage high risk patient transportation.

What’s next for NEMT?

The 2019 forecast is looking up for NEMT. With more lawsuits arising, not only are the current providers forced to reevaluate their processes; there’s room for new players to take over. In 2016 Lyft partnered with CareMore Health to provide NEMT services on a pilot basis. By 2017 the pilot was a full blown initiative. The impact of the Lyft-CareMore partnership is astonishing with a 39% reduction in transportation costs, a 45% decrease in wait times and a 96% member safety rating.
Indiana based LCP Transportation, a leader in non- emergency medical transportation in Indiana, is also planning to pick up the slack in the NEMT market. They offer state of the art phone systems, 24 hour dispatch and quality assurance, just to name a few. Their mission is to provide effective transportation solutions that enhance the quality of life to the communities they serve through innovative, practical and efficient services.
The health industry should expect to see major developments within the non-emergency transportation sector in the coming months. With companies like LCP and Lyft innovating NEMT solutions and organizations such as the Center for Consumer Engagement in Health Innovation boosting awareness and education, the advancement of NEMT has slowly become a dynamic movement.