An assessment of non-emergency medical transportation (NEMT) barriers in Texas and their impacts on access to and utilization of EPSDT services

The Texas Medicaid program provides transportation assistance to clients who have no other means of transportation to their medical appointments. This type of transportation is known as non-emergency medical transportation (NEMT). The Texas Health and Human Services Commission has identified transportation as a key issue inhibiting the full use of EPSDT services. A 2007 evaluation of NEMT services found that such services greatly contribute to access to care. Medicaid clients accessing NEMT services reported higher utilization rates (p<.05) of EPSDT checkups than those who did not. The study also sought to understand the barriers that prohibit access to care among non-users. While NEMT nonusers had significantly (p<.05) greater access to an automobile, the majority of Medicaid recipients are showing the strain of higher gasoline prices. When asked about the ability to pay for gasoline while traveling to medical and dental services, nearly 2/3 of respondents reported difficulties. These difficulties are resulting in missed opportunities for care. Forty-four percent of users and 30% of nonusers of NEMT services missed at least one appointment during the past year due to transportation difficulties. Over half of users and nonusers indicated the missed appointment was for an EPSDT checkup. Although NEMT has shown to increase access to care, barriers remain. Less than 10% of Medicaid recipients utilize program services and 70% of nonusers had no knowledge of the program. Thus, a substantial number of children could potentially benefit from NEMT services if aware of program services.