Non-Emergency Medical Transportation (NEMT)—A Critical Component of the U.S. Medical Care Delivery System

Non-Emergency Medical Transportation (NEMT) is provided to the portion of the Medicaid eligible population who have no other transportation options. NEMT appears to be cost effective for a number of medical conditions, and even money saving for others, at least as measured by Quality Adjusted Life Years (QALYs). NEMT can be delivered on a very large scale basis, partly because it is relatively low tech, and does not require advanced training. These two points suggest that NEMT can play (and already does play) an important role in delivering medical care in the U.S. For example, the NEMT program for the State of Delaware alone delivered almost 400 thousand trips in 2010 at a cost of under $12 per trip. Based on an analysis of the reasons for these trips, most would be highly cost-effective or even cost saving. Additional analyses show that the value of NEMT for the Medicaid population could be enhanced by (a) identifying strategies for increasing efficiency (reduce cancellations, focus on medical conditions where the service is cost effective or cost savings, and in general explore system optimization), (b) identifying current gaps (people missed, probably a function of condition, demographics, or location) and (c) calculating future needs (based on changing demographics, changing distribution of medical conditions, etc.). In a national context of (a) increasing medical care needs and (b) shrinking resources NEMT represents a critical and cost-effective component of the medical care delivery system.