CMS reports how increased NEMT implementation can deliver better access to care

Access to care is critical for positive health outcomes, and that remains true for members who receive Medicaid benefits. According to a recent report by the Centers for Medicare and Medicaid Services (CMS), approximately three to four million (four to five percent) of Medicaid beneficiaries used non-emergency medical transportation (NEMT) annually in 2018-2021, and states who used a broker to deliver NEMT saw the highest use of transportation services. Members with certain physical and mental conditions and those with a substance abuse disorder also had higher usage rates of NEMT than average Medicaid beneficiaries.

The move for better implementation

While there is some good usage of NEMT among Medicaid beneficiaries, there is more work to be done. The move for better NEMT implementation begins with state governments and health plans pursuing the advancement and education members need to access healthcare services. Many positive outcomes occur when members receive access to care, including:

• Better managed and preventive care efforts
• Decreased healthcare expenses
• Improved health outcomes

CMS’s report outlines recommendations that support a model of NEMT implementation among Medicaid beneficiaries, including:

1. Increase awareness of NEMT benefits

According to the report, knowledge of the NEMT benefit among Medicaid beneficiaries is low. Adopting awareness is crucial to implementation, and therefore states are urged to work with their health plans and providers to increase awareness and availability of NEMT. Many times, providers can work directly with NEMT brokers to develop marketing campaigns and collateral to promote the NEMT benefit and its advantages.

2. Find opportunities to improve operations between NEMT and public transit networks to better coordinate care

The CMS report discovered public transit is rarely used as an NEMT benefit, even though more than one-third of beneficiaries live in urban areas. Public transportation – coupled with private transportation – can provide ample opportunities to get members to their healthcare appointments.

3. Examine the role of NEMT in improving the use of timely preventative care

NEMT access is crucial to better health outcomes. But unfortunately, many are not getting the care they need. The National Library of Medicine reports NEMT barriers have caused more than 3.5 million people to miss their appointments, which can lead to progressive health issues, chronic diseases, poorer health outcomes, and excessive use of unnecessary resources. It also leads to missing other important outings, such as grocery shopping trips or visiting friends. The report concludes that “when patients have access to routine and preventive care, overall health outcomes are improved and costly ambulance bill and emergency department visits can be avoided.”

Collaborative partnerships are key for better NEMT implementation

These three findings uncover the important role NEMT plays in healthcare outcomes and the need for continued improvement. Together – as organizations, state governments, and private health plans – we can continue to build connections to care, such as offering additional NEMT access and knowledge of the benefit, that can improve health equity for all.