Improving Medicaid children's access to Medical Transportation Program in Texas: Strategizing policy prescriptions to address low utilization

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). Telephone survey data was collected between July 2007 and December of 2009 from 10,350 Medicaid-eligible EPDST clients in Texas who could access NEMT. The sample was randomly selected, stratified by user/non-user of the transportation system, public health regions, and urban/rural counties. From the data collected from the study, low utilization of MTP services appears to be a function of two domains: unmet need and poor understanding or knowledge of MTP and the services it provides. Based on collected data, we estimated that the number of THSteps recipients with unmet transportation needs was in excess of six times the number of THSteps recipients the program actually served over the past year and half. As for poor understanding of MTP and its services, we estimated the mean number of THSteps recipients without knowledge of the program at a staggering 52 percent over the past three years which is equal to 1.2 million. To address these problems, we suggest developing and exploring effective, broad and continuous outreach and informing strategies to increase knowledge of MTP. We also discuss strategies to identify and begin targeting the THSteps recipients in Texas who could potentially benefit from MTP services. The study implications are significant for future policy directions that Medicaid MTP services could take in Texas.