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The Impact Of Non-Emergency Medical Transportation (NEMT) Access On Healthcare Costs And Outcomes

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Access to transportation is a critical aspect of healthcare, yet it is often overlooked. The ability to travel to and from medical appointments, the pharmacy, and other health-related services is essential for maintaining good health. Unfortunately, many individuals, particularly older adults, face barriers to transportation that can have a significant impact on their healthcare outcomes. This paper will explore the impact that the lack of access to transportation can have on healthcare, with a specific focus on the elderly.

One of the most significant issues faced by individuals without access to transportation is that they are less likely to receive preventive care. Preventive care, such as regular check-ups and screenings, is crucial for detecting and treating health problems early on before they become more serious. Without access to transportation, individuals may be unable to make it to these appointments, leading to delayed or missed care. This can result in health conditions becoming more severe, which in turn can lead to increased healthcare costs and poorer physical outcomes.

Older adults are particularly vulnerable to the effects of a lack of transportation access. This is because as people age, they often experience more health problems and require more frequent medical care. Additionally, older adults may have mobility issues that make it difficult for them to access transportation. With 23% of older adults living in rural areas (Wallace et al., 2005), the problem is even more pronounced, as medical care facilities are not as common in these locations.

The cost of transportation can also be a significant barrier for the elderly, who are often on fixed incomes. In many cases they have been forced to retire because medical issues prevent them from being able to continue working. Many have to choose between paying for transportation to medical appointments and paying for other essentials, such as food and housing. This can lead to delayed or missed care, which can result in poorer health outcomes.

It is clear that there is a need for action to address the issue of transportation access and its impact on health outcomes. Ultimately, it is important that we view transportation as a critical component of healthcare, rather than as an unrelated issue or not an essential service. By working together, healthcare providers, insurers, and transportation providers can improve access to care and health outcomes for all individuals, particularly older adults.

The Impact of Transportation Access on Healthcare Costs and Outcomes

Transportation plays a crucial role in healthcare, as it determines whether or not an individual can access necessary in-person medical appointments and treatments. Access to transportation is a critical factor in determining the overall health and well-being of an individual, particularly the elderly. Missing or delaying appointments can lead to a decline in health and, in some cases, even death. According to a study, individuals without access to a vehicle visit the emergency room (ER) three times more per year than those with access. Additionally, people without access to a vehicle make 15?wer trips to the doctor than those with access, which can lead to more trips to the ER that could have been addressed with preventive care (Wallace et al., 2005).

The cost of transportation is also a significant issue. The average cost of an ER ride is $1,200 (Consumer Health Ratings, n.d.), while the average cost of a non-emergency medical transportation (NEMT) ride is $60 (Consumer Health Ratings, n.d.). With 40% of ER rides being non-emergencies, it is clear that the use of NEMT instead of ambulances for non-emergency situations could result in significant savings (Syed et al., n.d.). In fact, it is estimated that using NEMT instead of ambulances for non-emergency situations could result in savings of $6 billion on ER rides (n.d., 2020).

It is imperative to consider both the impact of transportation access on healthcare costs and the impact of transportation on healthcare outcomes when making policy and funding decisions related to non-emergency medical transportation. With the right investments and support, it is possible to improve transportation access for individuals and help to reduce healthcare costs and improve health outcomes.

Healthcare Policy

The findings of this study can have significant implications for healthcare policy. As we have concluded previously, without reliable transportation, individuals may struggle to reach medical appointments and may be at a higher risk of hospitalization, delayed diagnoses, and costly interventions. Additionally, the lack of transportation can lead to increased use of emergency services for non-emergency conditions, resulting in higher healthcare costs.

Healthcare policies must be revamped to address these issues. Here are some policy recommendations that are more inclusive:

1. Shift the view of NEMT from a regulatory mandate (exclusive to Medicaid patients) to a potential tool for better health and well-being for all patients:

Non-emergency medical transportation (NEMT) is currently seen as a regulatory mandate, meaning that it is a service that must be provided by each states Medicaid program. However, by shifting the view of NEMT from a mandate to a tool for better health and well-being for all patients, it can be used more strategically and effectively. This means looking at NEMT as an opportunity to improve access to healthcare for individuals who may otherwise struggle to get to appointments or treatments. It also means considering how NEMT can be used to prevent hospital readmissions, improve continuity of care, and ultimately improve patient outcomes.

2. Expand NEMT for individuals in need within all insurance programs, public or private, and uninsured:

Currently, NEMT is often only available to certain groups of individuals, such as those who are enrolled in Medicaid or other public programs for low-income individuals. However, to ensure that all individuals have access to the healthcare they need, NEMT should be expanded to include all insurance programs, public or private, and even the uninsured. This will help to eliminate barriers to care and ensure that everyone has the ability to get to the appointments and necessary treatments.

3. Identify clinical conditions of which in-person care provides the best possible outcome relative to virtual care modalities such as telehealth:

Telehealth has become increasingly popular in recent years as a way to provide healthcare services remotely. However, for certain clinical conditions, in-person care may be necessary for the best possible outcome. For example, certain diagnostic tests or procedures may need to be done in-person. Identifying these conditions and ensuring that NEMT is available for those appointments will help to ensure that patients receive the best possible care.

4. Modernize NEMT services to facilitate future improvements in productivity, costs, and service:

NEMT services are often operated using outdated systems and technologies. Modernizing these services can help to improve productivity, reduce costs, and improve the overall quality of service. This can include implementing new technologies such as scheduling software platforms, improving communication and coordination between NEMT providers, brokers and healthcare providers, and streamlining the process for arranging transportation.

5. Facilitate partnerships between state programs and private insurers to share resources:

Currently, state programs and private insurers often operate independently, which can lead to inefficiencies and duplication of efforts. By facilitating partnerships between these entities, resources can be shared and efforts can be better coordinated. This can include sharing information about patients and their transportation needs, coordinating transportation services, and working together to identify and address transportation barriers.

6. Invest in pre-existing transportation networks to deepen ties with disabled individuals, non-English speakers, and underserved areas:

Many communities already have transportation networks in place, such as bus or train systems. Investing in these networks can help to improve access to healthcare for disabled individuals, non-English speakers, and individuals living in underserved areas. This can include improving accessibility, providing language assistance, and ensuring that transportation services are available to those who need them.

7. Collaborate between digital-divide advocacy and transportation-divide advocacy to improve access to care and health outcomes:

A lack of transportation disproportionately affects marginalized communities such as those living in rural areas, individuals with disabilities, and non-English speakers. Also, there is a digital divide in access to technology and internet connectivity, which can further exacerbate healthcare disparities. By collaborating between digital-divide advocacy groups and transportation-divide advocacy groups, we can address these issues holistically and improve access to care for all individuals. This could include initiatives such as providing transportation to digital literacy training, or incorporating telehealth options into NEMT services for individuals without internet access at home. By addressing both transportation and digital divide barriers, we can ensure that all individuals have the necessary resources to access the healthcare they need.

It is important to note that these solutions are not mutually exclusive and can be implemented together to create a comprehensive transportation access policy that addresses the needs of all individuals without access to transport. With these policies in place, we can work towards a future where all Americans have access to the transportation they need for the healthcare they deserve.