NEMT Software for MCOs and State Agencies

How is Medicaid Changing in 2023? – NEMT Solutions and Opportunities

During the pandemic, we saw an increase in the utilization of Medicaid coverage, but as the world has adjusted we will soon be seeing a federal scaling back of eligibility. The Consolidated Appropriations Act—passed December 2022—ended Medicaid continuous enrollment on April 1st of this year.

This could mean changes are coming to the client base for NEMT brokers, MCOs, homecare providers, and more. It’s for this reason that we wanted to delve deeper into the topic. We found some keen insight into these changes in an article from the Kaiser Family Foundation.

Changes Noted During the Past Couple of Years

  • 35 out of 41 states reported that 75% of their Medicaid beneficiaries are part of an MCO since July 1st of last year. With the changes implemented with the Consolidated Appropriations Act, this will mean that MCOs may play a major role in helping their members maintain coverage.
  • States are taking steps to expand access to behavioral health services (mental health and substance use disorders). Around 39% of those using Medicaid have a mental health or substance use disorder.

    What to Watch Out for and Possible NEMT Solutions and Challenges

    • Workforce shortages in long-term care were made crystal clear. Nearly every state reported a lack of personnel in this field. This presents an opportunity for NEMT providers of all sorts to provide NEMT solutions that can help cover certain gaps in care. We would suggest collaborating with local LTC providers to see where you might be able to help.
    • A newly proposed rule about eligibility could mean an increase in Medicaid beneficiaries in demographics such as older adults and people living with differences in ability. As we’ve discussed before, the best way to prepare for this kind of change is to speak directly to that demographic about their needs whenever possible and to offer supplemental training to help your team better serve specific kinds of members and participants. We might also suggest looking into non-emergency medical trip technology that can help you streamline your processes.
    • Both the Biden Administration and state governments are strategizing to use Medicaid to help better address social determinants of health (SDOH) with managed care options and more. So we recommend that MCOs and others look further into how SDOHs affect the NEMT industry and how businesses in this field can work proactively to bridge crucial gaps and be part of the solution, instead of being part of the issue.

    Your Next Steps
    Because you’re here reading this article, you’ve already made a great step in being ready for what could be a major change: you’re doing your research. Momentm will continue to provide key insights into relevant news and NEMT solutions, so we encourage you to keep an eye on us.

    If you’re looking for further guidance or for NEMT technology to help support you, contact us and we’d be happy to speak with you.

    Kris Lyon

    Kris, VP, Business Development, specializes in adapting the operational needs of customers to Momentm's NEMT software platforms. With a strong 30+ year history working in the Health and Human Services field, Kris provides insight into the health care industry and its relation to medical transportation.

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