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MTAC Supports State Action to Strengthen Access to Non-Emergency Medical Transportation

Aug 15, 2022 | In the NewsPress Release

The Medical Transportation Access Coalition (MTAC) applauds recent state action for promoting policies that expand and strengthen non-emergency medical transportation (NEMT) benefits for low-and middle-income adults.  Specifically, through recent Section 1115 demonstration activity, Connecticut and Utah have expanded NEMT benefits for vulnerable populations that have not previously had access to this important benefit. Transportation has long been known to be a barrier to accessing healthcare and policies such as these help improve the lives and health of those in most need.

MTAC strongly supports the work of Connecticut Governor Ned Lamont and the state of Connecticut in introducing and implementing the Covered Connecticut Section 1115 demonstration waiver. Specifically, the state’s proposal will extend NEMT benefits to eligible qualified health plan members (QHP) that are comparable to NEMT benefits covered by Connecticut Medicaid. We also applaud Utah’s recently approved Section 1115 demonstration extension, the “Medicaid Reform 1115 Demonstration” which removes a harmful provision that excluded NEMT benefits for low-income adults with children. As a result, all Medicaid low-income adults in Utah will receive full state plan benefits by December 31, 2023 including NEMT regardless of whether or not they have children.

Section 1115 of the Social Security Act allows the Secretary of the U.S. Department of Health and Human Services, by way of CMS, broad flexibility to approve Medicaid demonstrations that are likely to further the goals of the program. The NEMT benefit has been part of the Medicaid program since its inception and is deeply rooted in the notion that for Medicaid to achieve its central goal – to provide medical assistance – it must also enable access to medically necessary services. Connecticut’s demonstration, in promoting affordability and access through a NEMT benefit offered to a broader population, will certainly advance these goals. By the same token, Utah’s prior waiver – which restricted NEMT for low-income adults with children – ran counter to the goals of Medicaid and was rightly ended by the state in coordination with CMS.

Robert Pittman, Senior Vice President of Government Affairs at ModivCare, stated, “Medicaid NEMT facilitates access to care for low-income beneficiaries who lack reliable affordable means of getting to health care appointments. Expanding the NEMT to a wider group of vulnerable individuals will reduce missed hospital appointments and improve overall population health.”

Phil Stalboerger, Vice President of Public Affairs, quotes, “Connecticut and Utah are two examples of using evidence-based policymaking to guide government policy. The NEMT program has a proven track record of improving health outcomes and increasing access to necessary healthcare services.”

“States are working to improve program administration, program integrity, and beneficiary experience. NEMT plays a critical role in promoting access to care and can help address each of these factors,” quoted Dena Adams-McNeish, Chief Development Officer at Southeastrans.

MTAC was formed 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. MTAC applauds and actively supports all state efforts to strengthen NEMT benefits and expand necessary access to these services to vulnerable populations. MTAC is committed to working with states to promote similar policies.

Silver Service Michigan Transportation

Non Emergency Medical Transport

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MTAC Releases First In-Depth Study on NEMT Use by Race and Ethnicity

Jan 11, 2023 | In the NewsPress ReleaseUncategorized

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.

Silver Service Michigan Transportation LLC