Age patterns in eligibility versus actual use of non-emergency medical care transportation services

Lack of access to non-emergency medical transportation (NEMT) contributes to underutilization of medical care and increased need for emergency medical care. Although access to NEMT would appear critical for disadvantaged older adults, few studies have documented the use of Medicaid funded NEMT across populations eligible for such services. This study used proprietary data from two states to examine NEMT use among Medicaid individuals eligible for such services cross-sectionally and over time. Of 158,117 Delaware residents who were eligible for Medicaid brokered transportation services in 2010, 16,195 (10.2%) used the service. The proportion of eligible persons who used NEMT increased significantly with age. Close to half (42.8%) of eligible persons age 65+used NEMT compared to 9.1% of those younger than age 65. The proportion of users and eligible persons living in rural areas did not differ; however, older women in predominantly rural settings had the greatest proportions of eligible persons who used NEMT. The length of time using NEMT services was also examined. A total of 34,084 older individuals used NEMT between 2006- 2010. Turnover was high—about 35 to 40% of current members each year were not members the following year and, about 40% of members in any one year were new.. While the number of older adults using NEMT increased 24% between 2006 and 2010, the overall rate of growth in membership declined. These findings demonstrate that the need for NEMT is particularly high among older adults but the duration for the need for these services is relatively short.