Assurance of access to health care is a basic feature of the Medicaid program that serves the nation’s poorest and most vulnerable populations. As a requirement to provide non-emergency medical transportation (NEMT), states recognize transportation as a fundamental aspect of healthcare (Medicaid’s Medical Transportation Assurance, 2009). NEMT is the federal government’s largest program for human services transportation.
States administer the Medicaid program and each state has its own rules and regulations. For this reason, coordination of NEMT with public transit and human services transportation is highly dependent on each state Medicaid agency’s policies and procedures. Over the past decade, many state and federal transportation agencies have encouraged coordinating NEMT with other publicly funded transportation services. In recent years, however, some state Medicaid officials have created brokerage and other initiatives that focus exclusively on the transportation needs of Medicaid recipients. Public transit agencies, particularly in rural areas, mobility managers, and proponents of transportation coordination have expressed concerns about this trend.
The objectives of the research are to present options for providing Medicaid-funded NEMT services and to compare and contrast the effects of the different options on:
- Access to Medicaid services;
- Human services transportation; and
- Public transit services.
The research will assist state-level policymakers, program administrators and other stakeholders to gauge the effect of different NEMT service-delivery options on transportation coordination, customer service, and cost-effective community transportation services.
Literature Review Key Points And Emerging Themes
State-By-State Medicaid NEMT Profiles
Get the PDF: State by State Profile Update as of December 2015
Interim Report Excerpts
Case Study Research
The Research Team completed the in-depth case study field work and is now vetting the preliminary reports. The in-depth case study states included a cross-section of seven states with a variety of Medicaid NEMT models. The seven case study states are: Florida, Massachusetts, New Jersey, North Carolina, Oregon, Pennsylvania, Texas.
What We Found So Far
Over the past decade, many states and federal transportation agencies have made progress in coordinating public transit and human service transportation–meaning coordination of a variety of trips including Medicaid, general public and human services trips on the same vehicle. As more states consider and implement brokerage options for Medicaid non-emergency medical transportation (NEMT), the discussion of coordination and the role of transportation is changing. Public transit providers, the private industry and healthcare stakeholders are reformulating what coordination means. The concept of coordination has broadened from transportation only coordination, to include transportation and healthcare coordination. Stakeholders involved in NEMT have multiple perspectives and differing policies and practices that influence the success of transportation/ healthcare coordination. The case study research reveals strengths, challenges and opportunities in how policies and practices impact coordination of transportation and healthcare.
Where We Are Headed: Handbook Development
The Handbook, the key product of this project, will provide information to all stakeholders on how NEMT policies, practices and models can impact transportation/ health coordination. The Handbook will also provide public transportation providers with information on best practices to best position themselves in the current NEMT environment. Guidebook publication is expected Spring of 2016.
The Research Team
- Suzie Edrington, Texas A&M Transportation Institute (TTI), Project Director and Co-Principal Investigator
- Jon E. Burkhardt, Jon E. Burkhardt Consulting, Co-Principal Investigator
- Linda Cherrington, TTI
- Pat Weaver, Kansas University Transportation Research Institute
- David Raphael, Community Mobility Solutions
- Stephen Borders, PhD, MSHP, Grand Valley State University
- Ross Peterson, C.R. Peterson Consulting
- Jeremy Dalton, C.R. Peterson Consulting
For More Information
Associate Research Scientist, TTI Transit Mobility Program, Houston, Texas Office