July 8, 2019
By Naomi Lopez Bauman

The Medicaid program, which was originally created in 1965 to provide healthcare services to the nation’s indigent and disabled, is funded by both the federal government and the states. Like most bureaucratic government programs, the program is often difficult to modernize. That is why, when there is progress, it should be both celebrated and replicated.

Under the Medicaid program rules, transportation to attend medical appointments must be provided to some Medicaid patients who lack access to transportation. Formally called “non-emergency medical transportation” (NEMT), ride-sharing is increasingly being used by private healthcare insurers and providers to ensure that patients make it to their appointments.

And now, Arizona is the first state to use a ride-sharing service for some of its Medicaid patients. According to the director of Arizona’s Medicaid agency, Jami Snyder: “We are proud to be the first Medicaid program in the country to establish an innovative regulatory approach that seamlessly offers rideshare as a non-emergency medical transportation option for Medicaid beneficiaries, who do not require special assistance during transport to and from medical appointments. This is a significant step forward in medical transportation services and we look forward to seeing its positive impact.”

A lack of reliable transportation is often cited as a leading cause of missed appointments in the Medicaid program. This not only impacts the too-few providers who are willing to accept Medicaid patients and receive no payment when an appointment is missed, but it can also have negative health consequences for patients who do not obtain timely diagnosis and/or do not adhere to their medical protocol.

It is the hope is that, by offering reliable and lower-cost transportation, Medicaid providers can more effectively manage patients’ care and contribute to better patient outcomes—at a lower cost to taxpayers who foot the bill for the program. While Arizona is the first state in the nation to integrate this approach into its Medicaid program, Florida and Texas won’t be far behind, as both states have passed laws to take the same approach.

Medicaid now accounts for more than one-quarter of state budgets (when counting federal and state funding) compared to 11 percent in 1988. This trend is unsustainable, as Medicaid threatens to squeeze out spending for other state priorities, such as education.

That is why this author and Rea Hederman of the Buckeye Institute created the Medicaid Policy Toolkit, which offers state lawmakers approaches for improving patient care while protecting taxpayer resources. Ride-sharing services to provide for dependable and more affordable transportation for Medicaid patients is one of twenty recommendations included in the report.

This approach is a likely win for many patients who lack reliable transportation, for taxpayers who are footing the bill for the program, and for the providers whose job it is to care for their patients. This small improvement is but one example of how and why state lawmakers can reform their Medicaid programs.

Naomi Lopez Bauman is the Director of Healthcare Policy at the Goldwater Institute.

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