What is a non-emergency business for medical transportation? NEMT services allow people to get to pre-scheduled healthcare appointments. This includes doctor visits, rehab, follow-up exams, and clinical testing.
Rural communities continue to see a growing need for reliable and safe public transportation, especially for those with disabilities and medical conditions. Read on if you are interested in starting a NEMT company.
The current state of the NEMT industry
“Transportation issues shouldn’t prevent anyone from getting to or from a doctor’s appointment,” explains Imran Cronk, staff writer for the popular life sciences and medicine journalism website STAT.
They do this for an estimated 3.6million Americans. Many of these people don’t have access to cars or public transportation. Cronk says that others can’t afford Ubers or taxis.”
There is a growing market opportunity in the NEMT services industry. There is an increase in the number of disabled and elderly patients. The Affordable Care Act has made it easier for patients to get preventive and follow-up treatment. In most areas, there simply aren’t many wheelchair-accessible vehicles in public transportation fleets.
Josh Komenda, CEO of VEYO, suggests that there’s a large population of those who need non-emergency medical transportation, especially for medically frail or elderly people in rural areas. Many people don’t have access to a vehicle or a driver’s license. They are often geographically isolated or cannot access public transport for developmental, mental, and physical reasons.
Some telling statistics reveal a litany of challenges, as well as business opportunities.
32 states reported that there were more than 59,000,000 total Medicaid NEMT trips between 2015 to 2018, for issues related to behavioral health, dialysis, preventative care, and specialist care.
Our health care system suffers an extra $150 billion in expenses primarily due to a refusal of care, delays in care, and missed appointments.
A recent report The Kaiser Commission on Medicaid and the Uninsured reveals that over 3.6 million patients elect to dismiss or delay necessary medical care each year because they don’t have transportation.
Legal structures for medical transportation companies
Your legal structure for your non-emergency transport business can have far-reaching consequences, both in terms of partnering with payment providers as well as tax responsibilities.
NEMT businesses may be sole proprietorships, partnerships, or LLCs. An attorney can help you choose the right legal structure for your business.
It is possible to modify your legal structure. However, this is not ideal. As you create your business plan for your NEMT, consider the potential evolution of your company and your growth expectations. Attention to detail will inspire confidence in potential investors, and help you secure financing to get the best possible start. Beyond legal structure considerations, use a business plan template to help you make sure that you’ve thought through every aspect of your business.
NEMT licensing and certification. Insurance requirements
The non-emergency sector of medical transport is still relatively young as a formal niche, both in terms of technological innovation and federal regulation.
Although there are not any guidelines for the entire NEMT industry, every state has its own set of operational rules and regulations that all companies must follow.
NEMT certification elements
Currently, NEMT operators don’t have to meet the same educational and training requirements as those in ambulance transport. Your staff should still be certified in basic medical emergency medical care, such as CPR, defibrillator operation, and vitals assessment.
Certification courses will become a standard as the industry grows and the demand for NEMT professionals increases.
NEMT licensing elements
Another important element in the non-emergency transport industry is vehicle licensing.
Double-check your requirements with the local bureau of a motor vehicle and ensure you are familiar with any standards for Medicaid transportation if offered.
- Penalty points for driving records
- An official certificate of driver’s health
- A policy of vehicle liability insurance
- Criminal background checks
- Evidence of negative random drug screenings
- Insurance elements for auto and liability
Driving patients is a risky business. There are traffic accidents and health-related events that can occur while driving to the hospital. Having adequate insurance is a critical part of starting a NEMT company. Although there aren’t any national guidelines regarding insurance policy elements or dollar amounts, it’s important to consult your provider to ensure you’re properly covered.
Most cases of coverage are based on two parts: coverage for each driver and coverage for the entire company. So that your company doesn’t become bankrupt, make sure you fully understand the risks and liabilities.
ADA-compliant wheelchair-accessible vans and equipment
You will need the right vehicle if you want to start a transport company. You are likely looking for a van, minivan, or full-size bus that meets the Americans with Disabilities Act (ADA), and the ADA Standards for Accessible Design.
Compliance elements of the ADA
If your business meets the following requirements, your vehicles must be ADA compliant
- Employers with 15 or more employees in private companies
- Businesses that serve the public interest;
- All state and local government agencies.
Some ADA requirements include:
- Lift door height: 56″-door opening height
- Handicap liftClear platform 30″ x40″ wide
- Attachments for wheelchairsCapable of withstanding 2,500 pounds per leg
- Seat belt mechanism:4-pt. 4-pt. tie downs
- Interior lighting:One-foot candle for illumination
Be sure to think through the associated medical supplies you’ll need for your passengers–wheelchairs, gurneys, oxygen tanks, dialysis machines, for example. These extras will influence the size and floor plan of the vehicle you’ll need, and will no doubt affect your overall startup costs.
There are a few affordable makes and models of wheelchair-accessible vans that are ADA-compliant–either right from the manufacturing line or after an accessibility conversion.
- Ford Transit Wheelchair Transport Van: This handicapped wheelchair van comes ADA-compliant right out of the factory. This wheelchair van is large enough to fit a person comfortably and offers multiple floor plans.
- Toyota Sienna Wheelchair Van: This accessible vehicle is an ADA-compliant rear-entry wheelchair van that happens to be one of the more affordable mobility vehicles on the market.
- Legend Side Entry Handicap Van Conversion: Spacious side-entry accessibility using a powered ramp operated remote control or door side control.
Service, staffing, and payment.
You must be able to meet your customers’ needs on the front end. This means offering exceptional service with consistency and flexibility. This will require you to make smart hiring decisions and be open to learning, especially as your industry grows.
You’ll also need to examine ways to reduce costs and increase profitability on the back end.
Start thinking about:
- What services you offer and how efficient they can be delivered
- Finding the right people to work for and with you
- You have the right payment options to suit your audience
- Your dynamic marketing strategy or how to find clients
- Selection of service offerings and billing
No matter what service you offer, be sure to clearly communicate and itemize it. Customers should know exactly what they are getting and billing should be as transparent as possible.
Pricing your services
There are a few factors that will affect the price of your services:
- Geographic location
- Economic conditions
- Customers’ age and health
- The ability of the business to provide services economically
- Multi-service packages rates, referral discount programs, and frequent customer rewards are all ways to drive more business.
Recruitment of office staff
A mix of skilled professionals is required to staff a NEMT startup, including drivers who are competent.
Your staff will likely need to take on multiple roles, as with many startups. It is possible that you won’t be able to hire the ideal staff immediately. But even in the early days, it’s going to be important to have a solid training program for onboarding new hires.
How to determine payment options
Medicaid will likely be the primary payer of services. Your staff should be familiar with the detailed billing procedures and processes of Northwest haulage companies. This training will be ongoing and relevant to program changes each year.
It will be crucial to building relationships with insurance providers. Most likely, each insurer will have its own operating guidelines. This is the first challenge that should get easier over time.
Marketing strategy creation
Once the NEMT startup is complete, it’s time for potential customers, their families, and caregivers to be informed.
A multichannel, focused marketing strategy will pay off. The strategic marketing plan should include both traditional and digital advertising methods. This will ensure that the message is delivered to all audiences, online and offline. Establishing a marketing ROI tracking strategy can help determine which channels deserve the larger investment of capital.
In addition to paid marketing practices, the NEMT startup can increase ROI finding various unpaid–and sometimes earned–marketing opportunities.