Catch up Day 13 – Medicaid at 50: Transportation

Federal law requires state Medicaid programs to provide transportation to and from medical appointments (and related needs like picking up prescriptions). This is a really, really important benefit. Getting to the doctor can be difficult/impossible if your finances don’t allow you to own a car, or your health conditions prevent you from driving or taking public transportation (if it is available at all).

In practice, non-emergency medical transportation (NEMT) can be a big hassle. It could learn a thing or two from Uber when it comes to convenience. Drivers get lost or delayed, appointments get rescheduled last minute, and patients can end up waiting a long time. That said, it’s a great concept and NEMT programs could see quick improvements with better contracting and oversight between the state and companies who provide the services. NEMT is cheaper than using an ambulance, and ensuring that people can keep up with their appointments is far preferable to having people go to the emergency department for issues that could have been managed earlier.

Worrisomely, NEMT is one of the benefits that some states are looking to get exemptions from when they seek Medicaid expansion waivers. At a time when states like Oregon are showing that attention to social determinants of health matters for outcomes and cost, it seems counterproductive to weaken NEMT. Let’s hope that we can try improving non-emergency medical transportation services rather than losing this important benefit.


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