Economic Benefit of “Modern” Nonemergency Medical Transportation That Utilizes Digital Transportation Networks

Abstract

Objectives. To determine the economic benefit of “modern” nonemergency medical transportation (NEMT) that utilizes digital transportation networks compared with traditional NEMT in the United States. Methods. We used the National Academies’ NEMT cost-effectiveness model to perform a baseline cost savings analysis for provision of NEMT for transportation-disadvantaged Medicaid beneficiaries. On the basis of a review of the literature, commercial information, and structured expert interviews, we performed a sensitivity analysis to determine the incremental economic benefit of using modern NEMT. We estimated confidence intervals (CIs) by using Monte Carlo simulation. Results. Total annual net savings for traditional NEMT in Medicaid was approximately $4 billion. For modern NEMT, estimated savings on ride costs varied from 30% to 70%. In comparison with traditional, modern NEMT was estimated to save $268 per expected user (95% CI = $248, $288 per member per year) and $537 million annually (95% CI = $496 million, $577 million) when scaled nationally. Conclusions. Modern NEMT has the potential to yield greater cost savings than traditional NEMT while also improving patient experience. Public Health Implications: Barriers to NEMT are a health risk affecting high-need, economically disadvantaged patients. Economic arguments supporting modern NEMT are important given decreased support for human services spending.

Money Moves the Mare: The Response of Community‐Based Organizations to Health Care's Embrace of Social Determinants

“…[1][2][3][4] The growing literature on this subject indicates that interventions to provide housing, nutritional support, and transportation can both improve health and, in some settings, save costs for health care providers and payers. [5][6][7][8][9][10] These interventions often require collaboration between health care providers and community-based organizations (CBOs) with expertise in social service delivery. Addressing patients' social needs, even in partnership with CBOs, requires health care delivery organizations to make potentially substantial changes, including hiring new workforces and collecting new patient data.…”

“…H ealth care providers are increasingly incentivized by health policies to address the social determinants of health (SDOH) 1‐4 . The growing literature on this subject indicates that interventions to provide housing, nutritional support, and transportation can both improve health and, in some settings, save costs for health care providers and payers 5‐10 . These interventions often require collaboration between health care providers and community‐based organizations (CBOs) with expertise in social service delivery.…”

Effect of Interventions for Non-Medical Emergency Transportation: A Systematic Review

“…Those results are consistent with a modeling study, not included as empirical evidence, which estimated that with use of "modern" (ride-sharing services) non-emergency medical transportation there may be a savings of $268 per user compared with traditional means of non-emergency medical transportation. (30) A third conclusion is that the effect of providing non-medical transportation -such as to-and from-the grocery store, or shopping for other items needed for daily living, or social engagements -has essentially been unstudied. The one study that evaluated transportation including nonmedical needs was limited by methods issues (such as a high loss to follow-up) and a lack of reporting.…”

The implementation cost of a safety‐net hospital program addressing social needs in Atlanta

“…Transportation is a SDOH that is a well‐documented barrier to medical care 20,21 . Transportation interventions have demonstrated improvements in medical appointment show rates 22‐25 and providing rides may be cost saving; 26 although, more work in this area is needed 22,27 . Meeting social needs for patients (through, eg, social services, transportation, home visits) may improve health, reduce hospital readmission, and decrease health care costs 28‐33 .…”