The National Academies Press

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From page 64... ... 64 This chapter identifies 14 strategies to coordinate NEMT with human services transportation and public transportation in order to move toward the common desired outcomes. The previous chapter explains different stakeholder perspectives about NEMT and coordinated transportation. Read the entire page →
From page 65... ... Strategies to Achieve Common Desired Outcomes 65 agencies are typically responsible for defining NEMT service areas. Public transportation service areas may be defined by the state DOT (in particular, for rural transit) Read the entire page →
From page 66... ... 66 Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination transportation program management. Particularly in situations where state Medicaid agencies contract with other entities -- for example, brokers or MCOs -- standard procedures for collecting data and reporting performance for NEMT will help to inform all stakeholders. Read the entire page →
From page 67... ... Strategies to Achieve Common Desired Outcomes 67 ensure positive relationships with transportation providers and benefit from lower prices based on good business practices. Description of Strategies In the following boxes, each strategy is described -- its opportunities, challenges, stakeholder roles, examples, and useful resources. Read the entire page →
From page 68... ... 68 Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination Opportunities The federal transportation authorization bill, the FAST Act, stipulates public transit agencies should coordinate public transportation services with human services transportation. The coordination of NEMT with public transportation and other human services transportation can better meet the needs of transportation-disadvantaged individuals for all trip purposes to improve quality of life. Read the entire page →
From page 69... ... Strategies to Achieve Common Desired Outcomes 69 Strategy 3. Adopt common geographic boundaries for service areas. Read the entire page →
From page 70... ... 70 Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination Opportunities More research is needed to quantify transportation's contribution to improved health outcomes and related cost savings. Both medical and transportation providers can develop experience-based data to confirm the value of NEMT and transportation to other services and activities to keep people healthy. Read the entire page →
From page 71... ... Strategies to Achieve Common Desired Outcomes 71 Opportunities NEMT is necessary for access to medical care, particularly for Medicaid beneficiaries living in rural areas where travel distances to medical services can be long and transportation options are limited. Fewer transportation providers are available for NEMT in rural areas. Read the entire page →
From page 72... ... 72 Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination Opportunities The Medicaid program is changing from traditional, state-administered fee-for-service medicine to managed care or coordinated care that rewards medical providers for keeping people healthy and out of costly emergency facilities. At the same time, mobile technologies and ridesourcing companies are transforming transportation. Read the entire page →
From page 73... ... Strategies to Achieve Common Desired Outcomes 73 Strategy 7. Use technology to enhance NEMT program administration and verify medical trips. Read the entire page →
From page 74... ... 74 Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination Opportunities Obtaining high-quality, consistent data is a key to measuring performance, monitoring compliance, and addressing the other components of good transportation program management. Particularly in situations where state Medicaid agencies contract with other entities -- for example, brokers or MCOs -- standard procedures for collecting data and reporting performance will help to inform all stakeholders. Read the entire page →
From page 75... ... Strategies to Achieve Common Desired Outcomes 75 Strategy 9. Use fixed-route transit for appropriate NEMT trips at the lowest cost. Read the entire page →
From page 76... ... 76 Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination Opportunities Coordinating shared-ride, demand-response transportation can reduce the costs per NEMT trip by more efficiently using existing transportation resources (e.g., vehicles, drivers, and administrative staff) Read the entire page →
From page 77... ... Strategies to Achieve Common Desired Outcomes 77 Opportunities Public transportation providers can adopt a comprehensive cost accounting system that clearly identifies all costs incurred and all services rendered in order to establish and implement cost allocation to identify direct costs for coordinated services, including NEMT. A comprehensive cost allocation methodology can help to accurately document the direct costs of providing NEMT. Read the entire page →
From page 78... ... 78 Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination Opportunities When NEMT is provided for individuals with disabilities, a state Medicaid agency or an NEMT broker may have an opportunity to work with a public transit agency to establish a cost-effective rate per NEMT trip on ADA paratransit. CMS has stated that the DRA will permit a state Medicaid agency or broker to pay more than the public transit fare for an NEMT trip using ADA paratransit but no more than the rate charged to other human services agencies for similar trips. Read the entire page →
From page 79... ... Strategies to Achieve Common Desired Outcomes 79 Opportunities Stakeholder roles Resources Burkhardt, J Read the entire page →
From page 80... ... 80 Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination Strategy 14. Adopt procedures and timelines for invoicing and payment for NEMT. Read the entire page →

From page 64...

... 64 This chapter identifies 14 strategies to coordinate NEMT with human services transportation and public transportation in order to move toward the common desired outcomes. The previous chapter explains different stakeholder perspectives about NEMT and coordinated transportation.