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Health 277 views Aug 24, 2018
Non-Emergency Medical Transportation Saves Lives, says Study

In the past decade alone, there have been remarkable advances in medicine and medical treatment for a variety of diseases. They include treatments for end stage renal disease, diabetes, heart disease, cancer and many others.  Patients are living longer, and healthier lives.

Sadly, many patients can’t get to their appointments to see their medical provider. Transportation to and from their health care practitioner is dependent on public transit, taxis, rides from relatives or friends, and for some, their own vehicle.

Reimbursement from Medicaid

For those patients who are unable to get to and from their medical appointments on their own, Medicaid offers a non-emergency medical transportation (NEMT) benefit that is designed to cover the least costly and most appropriate method of getting people to their appointments. But it isn’t just a question of economics - getting patients to see their healthcare providers enhances the medical outcomes - which in itself offers significant monetary savings to Medicare.

As more and more medical care is offered on an outpatient basis, gaining access to their medical providers is crucial to lifesaving care. As more and more patients develop chronic medical conditions, healthcare transportation is becoming more and more important to saving lives. This is especially true for disadvantaged Medicaid recipients.

How prevalent are chronic conditions? The Centers for Disease Control estimates that about 78 percent of the adult population aged 55 and over has at least one chronic condition. On top of that, over 500,000 adults with serious behavioral health problems that can impair their ability to function. These patients also need nonemergency medical transport in order to get much needed treatments and health care services.

But on top of life-saving medical services, seeing a healthcare provider actually saves Medicaid money. By reducing the impact of chronic health conditions on patients, Medicaid saves money in the long run by paying for transport for medical appointments. In just one example of a study done on patients with kidney failure, transporting them to dialysis saves Medicaid $3,423 per month per patient. And for patients who receive care for diabetes related wounds, the savings are about $9,500 per year. Those are significant savings!

But even more striking is that more than 50% of beneficiaries participating in the study said they would be unable to keep their health appointments without NEMT. And 10% of respondents said they would be unlikely to survive without the service.

Available Solutions

One of the key strategies for making the most of nonemergency medical transport is to coordinate medical trips with other community transportation needs of similar populations using conversion vans. Instead of a one-purpose trip, the vehicle can be used for ambulatory and non-ambulatory patients - saving a large amount of money.  Responsible conversion van manufacturers such as FR Conversions also offer emergency 911 kits as a low cost and very critical option.  A special needs van equipped with an emergency 911 kit can make all the difference in the world in the event of a serious medical situation.

Currently, Medicaid agencies pay for a large portion of the non-emergency transportation services. But there are many regulatory barriers that prevent states from realizing any savings from these programs. So many states are using private brokers to manage Medicaid transportation services.

However, 28 states still are not coordinating transportation with their Medicaid agency due to a lack of a coordinating council. One example of this is that one state may send oneparatransit van to transport a disabled veteran, while another vanis dispatchedto a Medicaid patient who lives just one block away.

Some Medicaid agencies are using a fee for service model, but costs are variable and hard to budget. Some states use public transportation for Medicaid recipients, while others useprivate vehicles when public transit isn’t available. And other states used managed care as their model. Some states use community health workers to transport patients to their healthcare providers using mobility vans, often to accommodate wheelchair or stretcher patients. These workers are particularly helpful in rural areas where the is no public transit option.

Much work still needs to be done, but it is clear that providing non-emergency medical transport to the aging population is saving lives.