Federal transportation policy calls for coordination of public transportation with human services transportation to avoid duplicative and overlapping services and to achieve cost savings for all federally funded programs. The Medicaid program is the largest federal program for human services transportation, spending approximately $3 billion annually on NEMT. The successful coordination of transportation services is affected by the extent to which resources for NEMT are coordinated with and complement public transportation and other human services transportation programs. Because the Medicaid program is administered by states, which are able to set their own rules, within federal regulations and guidelines set by the Centers for Medicare and Medicaid Services (CMS), coordination of NEMT with public transit and human services transportation is highly dependent on each state Medicaid agency’s policies and priorities.
Most research conducted on NEMT brokerages has focused on the impacts on the specific Medicaid program and agency. Meanwhile, the broader fiscal, coordination, and customer service effects of statewide Medicaid NEMT brokerages have not been fully studied. As more states consider the statewide or regional brokerage options for NEMT, it is important to determine (1) what the larger outcomes are for human services transportation and public transit, (2) what motivates states to establish separate NEMT brokerages, and (3) what the actual costs and benefits are.
The objectives of this research are to present options for providing Medicaid-funded NEMT services and evaluate the effects of different options for providing NEMT on: (1) access to Medicaid services; (2) human services transportation (in particular, coordinated transportation services); and (3) public transit services, including ADA complementary paratransit services. The key audiences for this research include state-level policymakers and program administrators and other stakeholders affected by the different options for providing NEMT services.
STATUS: The research has been completed and has been released as TCRP Report 202, Examining the Effects of Separate NEMT Brokerages on Transportation Coordination: A Handbook. The report is accompanied by a companion document that explores the state-by-state profiles for examining the effects of NEMT brokerages on transportation coordination.