A Ride to the Doctor: Critical for West Virginians on Medicaid
During the 2018 West Virginia legislative session, a couple rumors circulated about proposals to change the non-emergency medical transportation (NEMT) benefit in our state's Medicaid program. For a rural state like West Virginia, this is a critically important benefit. Luckily, these proposals did not gain traction and the NEMT benefit remained intact.
For example, a woman on Medicaid diagnosed with breast cancer who is getting treatment at WVU hospital's Betty Puskar Breast Cancer Center is able to getstate-of-the-art care and treatment. However, if she lives in the Eastern Panhandle or in the southern counties of our state, she can face a long drive - 3 hours or more - to receive that treatment. The cost of gas alone can be more than a patient can afford.
For others, just getting to the local doctor can be challenging because they don't have a car and family members work and can't just take off to help.
Here's some facts about the non-emergency medical transportation benefit in Medicaidand and why it is a good investment for West Virginia.
NEMT is Cost-Effective
A study of non-emergency medical transportation and health care access found that NEMT benefits are cost-effective or cost-saving for all 12 medical conditions analyzed, such as prenatal care, asthma, heart disease and diabetes.
While NEMT makes up less than one percent of total Medicaid expenditures, emergency room visits result in 15 times the cost of routine transportation.
Another estimate calculates $11 saved for up to each dollar spent on NEMT if one percent of total medical trips resulted in avoiding an emergency room visit.
NEMT Benefits Help Medicaid Expansion Populations Access Important Preventive Services
An independent evaluation of Indiana’s NEMT waiver found that transportation was identified by the largest proportion of members as the “most common” reason for missing an appointment.
Expansion populations are more likely to use the benefit to access cost-effective preventive services than traditional Medicaid populations.
Transportation Barriers Lead to Delayed or Missed Care for Consumers
Evidence shows that adults who lack transportation to medical care are more likely to have chronic health conditions and without adequate transportation, these conditions are likely to go unmanaged and eventually lead to costly emergency care and treatment that could have been prevented.
A January 2016 report by the United States Government Accountability Office concluded that the NEMT benefit “can be an important safety net for enrollees as research has identified the lack of transportation as affecting Medicaid enrollees’ access to services.”