WASHINGTON (August 1, 2018) –   A newly released study commissioned by the Medical Transportation Access Coalition (MTAC) confirms Medicaid NEMT is a highly cost-effective, public-private partnership that helps assure the health and well-being of millions in America. It saves Medicaid, and thereby taxpayers, more than $40 million per month for every 30,000 beneficiaries receiving treatment for one of three conditions covered in the study.

The first-of-its-kind study used Medicaid claims data and a survey of nearly 1,000 Medicaid beneficiaries to determine their usage and the benefits realized. Their research focused on three relatively common and expensive diseases for which Medicaid beneficiaries were transported to and from medical appointments – kidney dialysis for patients suffering end-stage renal disease, diabetic wound care and treatment for substance abuse disorders.

“As we surveyed nearly 1,000 vulnerable users of NEMT, we heard again and again about the importance of this benefit,” said Mike Adelberg, a principal with Faegre Baker Daniels Consulting and co-author of the study.

Fifty-eight percent of beneficiaries participating in the survey said they would not be able to keep their medical appointments without access to NEMT. Even more sobering, 10 percent of respondents said they “would die” or “probably would die” without access to NEMT.

Based on an analysis of Medicaid claims data for the noted conditions, the study’s administrators calculated an average overall monthly medical expenditure for beneficiaries who adhered to clinical protocols and those who failed to maintain regular treatment sessions. They determined that beneficiaries who used NEMT services for scheduled medical appointments based on prescribed treatment regimens – such as the clinically recommended number of dialysis sessions or wound treatments – enjoyed better health and incurred significantly lower long-term costs than those that didn’t maintain regular appointments.

“Now that we’ve crunched the numbers, we see that for the conditions we examined, NEMT is also a benefit to Medicaid’s coffers. Win-win scenarios are uncommon in public programs—this appears to be one,” Adelberg added.

Across the three groups, the monthly cost-savings per Medicaid beneficiary averaged more than $1,300.

Specifically, the study identified significant cost avoidance for Medicaid beneficiaries with kidney failure who rely on non-emergency medical transportation to attend dialysis treatments. Consistent with clinical guidelines, survey respondents reported attending an average of 12 dialysis treatments a month using non-emergency medical transportation and said they would expect to attend an average of only 4.1 treatments a month without it.

This reduction would likely lead to expensive emergency dialysis treatments and hospitalizations. Ultimately, the study concluded that non-emergency medical transportation saves Medicaid $3,423 per month for each individual with kidney failure receiving dialysis, or $41,076 per-beneficiary, per-year.

Relatedly, NEMT for Medicaid beneficiaries with diabetes-related wounds was also associated with avoiding significant costs. Survey respondents reported attending an average of 5.5 wound care treatments a month using non-emergency medical transportation but expected to attend an average of only 1.3 treatments a month without it. Ultimately, Medicaid would avoid spending $792 per member per month, or $9,504 per year, by keeping patients on a path to receive all necessary wound-care treatments.

“These results remind us of the importance of access to care. It is scary to think of end-stage renal disease patients getting fewer than six treatments per month,” said Jackson Williams, director of regulatory affairs for Dialysis Patient Citizens, a Washington-based, nonprofit advocacy organization dedicated to improving quality of life for dialysis patients and an MTAC affiliate.

“Optimal dialysis care and improving the quality of life for all patients starts with getting them to dialysis centers. Well-managed Medicaid NEMT, especially for our patient population, means better health, fewer complications and lower costs,” Williams added.

The MTAC study clearly shows the nation’s non-emergency medical transportation system promotes better health outcomes for the most frail and vulnerable citizens. It pays for itself many times over by reducing medical costs that would otherwise be incurred by Medicaid in the form of higher costs associated with more intensive or more frequent use of healthcare services.

“We are pleased with the findings and hope governors, legislators, members of Congress and the administration will continue supporting policies that provide NEMT services for Medicaid beneficiaries,” said LogistiCare CEO Jeff Felton. “Many lack access to reliable transportation and those that rely on the benefit do not have the means or personal resources to keep their medical appointments without it. NEMT is an essential component in a healthcare system for those in greatest need.”

About the Study

Funded by the Medical Transportation Access Coalition, the study was conducted by a team that included Faegre Baker Daniels Consulting, Wakely Consulting and Dr. Patricia Salber, a board-certified physician and author. The study is the first of its kind that used actual Medicaid claims data along with a survey of NEMT users to determine the impact policies limiting the benefit would have on beneficiary health and the cost to Medicaid.

Source: MTAC (Medical Transportation Access Coalition)

Additional Study Resources

Study One-Pager Summary

Study Slide Deck

Study Methodology

Claims codes used to identify beneficiaries