An Overlooked Lifeline for Older Adults

“When I first booked transportation for my kidney dialysis, they would not let me book more than one month out at a time. What did they think was going to happen, I would stop needing dialysis?” —Diana, on trying to access Medicaid’s non-emergency medical transportation

Diana is one of 7.1 million Americans who rely on Medicaid’s non-emergency transportation benefit (NEMT) to help her get to her medical appointments. NEMT is an important Medicaid benefit for the people who rely on transportation services to help them visit their doctors, receive treatment for chronic conditions, and travel to settings such as adult day health care. Yet, every year, an estimated 3.6 million Americans miss or delay health care because of difficulty accessing these critical services. When transportation services work, they help people get to their doctors and other needed health services so they can continue to live at home and in the community. When they do not work, Medicaid beneficiaries like Diana are left stranded, frustrated, and without access to needed medical care and services.

As the country’s population ages and as health programs better support people’s desire to live independently rather than in institutions like nursing homes, demand for transportation services will continue to increase. Along with increased demand, policy factors, like changes in Medicaid funding and the shift to delivery of Medicaid services through managed care, have created additional challenges that make it difficult to adequately meet the growing NEMT need.

When people can reliably reach their doctors to get routine medical care and treatment in their communities, they are less likely to be admitted to a hospital or nursing home to get the care they need. Considering that, in total, NEMT represents less than 1% of total state and federal Medicaid expenditures and has the potential to prevent much more costly medical care, it provides good value for the states. With our partners Community Catalyst’s Center for Consumer Engagement in Health Innovation, we released a new issue brief today: Medicaid Non-Emergency Medical Transportation: An Overlooked Lifeline for Older Adults. The brief outlines the importance of NEMT for older adults and people with disabilities, details the challenges faced by users, and offers a series of recommendations based on promising state practices.

Overall recommendations for improving NEMT include:

  1. Negotiate stronger contracts with transportation brokers that use data-driven benchmarks to hold them accountable
  2. Improve data collection and transparency through a consumer reporting system
  3. Improve oversight at the state and federal level and seek stakeholder engagement
  4. Manage contracts at the state level to improve access in rural areas

States and the federal government need to prioritize improvements to the NEMT system in order to address the challenges consumers face in accessing these critical services. Increased transparency, oversight, reporting, and accountability can create a better functioning system that will protect the rights of consumers.

Watch today’s NEMT webinar and download the slides here.

About Fay Gordon

Fay Gordon is a Staff Attorney in Justice in Aging's Oakland office