A new report released today by the Center for Consumer Engagement in Health Innovation (the Center) and Justice in Aging outlines the importance of Non-Emergency Medical Transportation Services (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. The report, Medicaid Non-Emergency Medical Transportation: An Overlooked Lifeline for Older Adults, can be accessed at Justice in Aging and the Center.
Across the country, 7.1 million Americans rely on NEMT services to get to medical appointments. Yet, every year, an estimated 3.6 million Americans miss or delay health care because of difficulty accessing these critical services. NEMT is an important Medicaid benefit for the people who rely on it to visit their doctors, receive treatment for chronic conditions and travel to settings such as adult day health care. Considering that NEMT represents less than 1 percent of total state and federal Medicaid expenditures and has the potential to prevent much more costly medical care, it provides exceptional value for states.
“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,” said Fay Gordon, Staff Attorney at Justice in Aging and the author of the report.
As part of the Deficit Reduction Act (DRA) in 2005, states gained the flexibility to contract NEMT services out to transportation brokers. Currently more than 39 states do so. Brokers, in many cases, act as administrative gatekeeper, call center and transportation case coordinator. There is little state or federal oversight of these transportation brokers, and limited accountability. Consequently, problems with consumers being able to access reliable transportation have been widely documented and reported in the media.
“What’s the point of patients having an appointment, if they can’t actually get to it? As a primary care physician, I have seen how distressing it is when my frail patients are left stranded because their transportation didn’t show up,” said Dr. Ann Hwang, Director of the Center for Consumer Engagement in Health Innovation. “This is a critical lifeline for some of the most vulnerable members of our community who need reliable access to health care. Making the service work better will ensure people get the care they need to take care of their health.”
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.
- Negotiate stronger contracts with transportation brokers that use data-driven benchmarks to hold them accountable
- Improve data collection and transparency through a consumer reporting system
- Improve oversight at the state and federal level and seek stakeholder engagement
- Manage contracts at the state level to improve access in rural areas
Justice in Aging is a national non-profit legal advocacy organization that fights senior poverty through law. Formerly the National Senior Citizens Law Center, since 1972 we’ve worked for access to affordable health care and economic security for older adults with limited resources, focusing especially on populations that have traditionally lacked legal protection such as women, people of color, LGBT individuals, and people with limited English proficiency. Through targeted advocacy, litigation, and the trainings and resources we provide to local advocates, we ensure access to the social safety net programs that poor seniors depend on, including Medicare, Medicaid, Social Security, and Supplemental Security Income (SSI). For more information, visit our website at justiceinaging.org. Follow us on Twitter @JusticeinAging
The Center for Consumer Engagement in Health Innovation at Community Catalyst is a hub devoted to teaching, learning and sharing knowledge to bring the consumer experience to the forefront of health innovation in order to deliver better care, better value and better health for every community, particularly vulnerable and historically underserved populations. The Center’s work is supported through investments in state and local advocacy, leadership development, research and evaluation, and consultative services to delivery systems and health plans. Visit healthinnovation.org or follow them on Twitter @CCEHI to learn more and follow their work.
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