Non-emergency medical transportation (NEMT) has experienced drastic growth due to the 2020 mandate for all states to offer these services as a part of Medicaid. The rationale for this transition is to provide mobile assistance to all Medicaid beneficiaries by offering them access to non-emergent transportation. However, studies have shown that not all beneficiaries receive the same support, due to race and ethnicity. The Medical Transportation Access Coalition (MTAC) has released research focusing on the role of NEMT for Medicaid beneficiaries through the lens of race and ethnicity.
Varied Use of NEMT Services Amongst Racial & Ethnic Groups
The main findings indicated that American Indian and Alaska Native (AIAN) enrollees utilize NEMT benefits at the highest rates. The number of riders of these ethnicities using NEMT, as well as the number of days of the week they need to use these services (ride-days), are higher than all other racial and ethnic groups. Black enrollees had the next highest rates, while Hispanic enrollees had the lowest rates overall.
However, further findings indicate that certain racial groups make up a higher percentage of NEMT riders and the number of ride-days the use than they did enrollees, while others made up a lower share. This disparity is likely a result of NEMT not serving beneficiaries of different races and ethnicities equally, which suggests the need for more advanced education surrounding NEMT access to certain groups.
Not only does this report indicate the support required by racial and ethnic groups via NEMT services, but it also sheds light on the importance of NEMT services for certain racial and ethnic groups.
These findings were not consistent across all states. From state to state, there were drastic variations in how racial and ethnic beneficiaries used NEMT services. This prevents the possibility of implementing national requirements with the hope of addressing inequalities in access across the country. Instead, each state will need to consider different influential factors, such as rural versus urban NEMT use, racial and ethnic population percentages, and the discrepancy between enrollment versus rider use for each racial and ethnic group individually, as well as in relation to one another.
What’s Next? Identifying the inequalities that are present in NEMT usage for racial and ethnic groups is significant to understanding changes that need to be implemented to better support these groups of enrollees.
There is still a gap in the research surrounding NEMT services that need to be filled regarding racial and ethnic disparities in access to care. As part of this research, it will also be important to investigate whether racial and ethnic disparities are present in gaining access to NEMT specifically. Future research will be significant in understanding the disparities that need to be addressed and learning how to make NEMT services accessible to all racial and ethnic groups equally. As a social determinant of health, transportation will not only improve the quality of life of people of all ethnicities, but it will also improve health equity overall.
For NEMT to tackle this, industry professionals will need to not just look at the role that it plays alone. These crucial factors in health care don’t exist in a vacuum. They can—and often do—interact with other social determinants of health such as job status, housing, education, and more.
The differences in how racial and ethnic groups encounter and use NEMT from state to state demonstrate something we’ve emphasized in other posts previously: health care must be personalized and focused on quality. Every community’s needs differ for all manner of reasons. One of the best ways to meet these unique needs is to speak directly to the leaders in a community and to the people within a community.
If you’re looking for more direction, we’re always happy to talk. Let’s continue the conversation, get in touch today.