The Medical Transportation Access Coalition (MTAC), in collaboration with Faegre Drinker Consulting and the National Opinion Research Center (NORC), is pleased to announce the release of new research and data analysis on the role of non-emergency medical transportation (NEMT) for Medicaid beneficiaries. The research paper, titled “Understanding the Role of Non-Emergency Medical Transportation for Medicaid Beneficiaries by Race and Ethnicity”, provides the first in-depth analysis of NEMT use by Medicaid beneficiaries of different racial and ethnic groups, including by those with different health needs and socioeconomic characteristics.

At the core of NEMT is its role as an access-to-care enabler for Medicaid beneficiaries – a role that has been well-established through research and the experiences of beneficiaries and program administrators alike. However, to date, there are no studies examining NEMT’s role in overcoming racial and ethnic disparities in access to care, specifically; nor are there studies examining whether racial and ethnic disparities exist in access to NEMT itself.

“Documenting and reporting differences in how beneficiaries of different racial and ethnic groups use NEMT is an important first step in understanding opportunities to expand access to NEMT, and ultimately informing policy solutions to address inequities in access to care.” said Robert Pittman, Senior Vice President of Government Affairs at ModivCare.

MTAC partnered with NORC to examine 2019 data on NEMT use by race and ethnicity and several other enrollee characteristics from the Transformed Statistical Information System (T-MSIS) Analytic File (TAF) for 32 states and territories.

MTAC identified different subgroups within a state’s NEMT population to examine patterns and trends. Examples of subgroups include race, ethnicity, dually eligible, health conditions, rural vs. urban, among others. NEMT stood out as particularly important for enrollees of certain racial and ethnic groups belonging to certain subgroups. For example, Hispanic enrollees with opioid use disorder used NEMT at a high rate compared to other Hispanic subgroups (e.g., those with other conditions), as did Asian dually eligible enrollees compared to most other Asian subgroups.

The study also showed that NEMT use was not distributed across racial and ethnic groups equally, or in proportion to their enrollment, indicating that NEMT is not serving beneficiaries of different races and ethnicities equally and may suggest a need for focused education about NEMT to certain groups. However, in the high-need groups using NEMT at the highest rates (such as beneficiaries dually eligible for Medicare and Medicaid), each racial and ethnic group used a more proportionate share of NEMT.

Phil Stalboerger, Vice President of Public Affairs said, “The results underscore the importance of state- and local-level opportunities to improve access to care through NEMT, and of examining vulnerable subgroups, such as enrollees with end-stage renal disease, opioid use disorder, and other chronic conditions.”

Once differences in NEMT use have been identified, “the next step is for policymakers to address the root causes of these differences, with an eye towards ultimately ensuring that NEMT is available and accessible to all enrollees who might benefit.” said Dena Adams-McNeish, Chief Development Officer at Southeastrans.

MTAC (www.mtaccoalition.org) was formed in 2017 to educate federal and state policymakers and other stakeholders about the benefits of medical transportation and the need for policies that support continued access to these services. The coalition’s founding and allied members include a diverse set of transportation management services companies and providers, managed care organizations and trade associations, and patient advocacy groups. Read the full report here.