Source: Health Policy Institute of Ohio
For more than 50 years, Medicaid has been required to provide transportation for certain clients to and from medical appointments, but a few states have sought and received waivers to that rule (Source: “No Car, No Care? Medicaid Transportation at Risk in Some States,” Kaiser Health News, January 30, 2018).
Non-emergency medical transportation NEMT) has been included in Medicaid since its inception in 1966. Medicaid has been required to transport people to and from such medical services as mental health counseling sessions, substance abuse treatment, dialysis, physical therapy, adult day care, and visits to specialists.
Citing runaway costs and a focus on patients taking responsibility for their health, Republicans have vowed to roll back the benefits, cut federal funding, and give states more power to eliminate services they consider unaffordable.
Critics of the cuts worry the trend will accelerate, leaving poor and sick patients with no way to get to medical appointments. The Centers for Medicare and Medicaid Services released results of a 2014 survey of Medicaid users, which found that lack of transportation was the third-greatest barrier to care for adults with disabilities, with 12.2% of those patients reporting they couldn’t get a ride to a doctor’s office.
About 3.6 million Americans miss or delay non-emergency medical care each year because of transportation problems, according to a 2005 study published by the National Academy of Sciences. That same study analyzed costs for providing NEMT to patients facing 12 common medical conditions and found that providing additional transportation is cost-effective. For four of those conditions – prenatal care, asthma, heart disease, and diabetes – medical transportation saved money when the total costs for both transportation and health care were tallied.