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Economic Benefit of "Modern" Nonemergency Medical Transportation That Utilizes Digital Transportation Networks
Danielle H Rochlin1, Chuan-Mei Lee1, Claudia Scheuter1
1All authors are with the Clinical Excellence Research Center, Stanford University, Stanford, CA. Danielle H. Rochlin is also with the Division of Plastic and Reconstructive Surgery, Stanford University. Claudia Scheuter is also with the Division of General Internal Medicine, Inselspital Bern University Hospital, Bern, Switzerland.
Objectives:
To determine the economic benefit of "modern" nonemergency medical transportation (NEMT) that utilizes digital transportation networks compared with traditional NEMT in the United States.
Methods:
We used the National Academies' NEMT cost-effectiveness model to perform a baseline cost savings analysis for provision of NEMT for transportation-disadvantaged Medicaid beneficiaries. On the basis of a review of the literature, commercial information, and structured expert interviews, we performed a sensitivity analysis to determine the incremental economic benefit of using modern NEMT. We estimated confidence intervals (CIs) by using Monte Carlo simulation.
Results:
Total annual net savings for traditional NEMT in Medicaid was approximately $4 billion. For modern NEMT, estimated savings on ride costs varied from 30% to 70%. In comparison with traditional, modern NEMT was estimated to save $268 per expected user (95% CI = $248, $288 per member per year) and $537 million annually (95% CI = $496 million, $577 million) when scaled nationally.
Conclusions:
Modern NEMT has the potential to yield greater cost savings than traditional NEMT while also improving patient experience. Public Health Implications: Barriers to NEMT are a health risk affecting high-need, economically disadvantaged patients. Economic arguments supporting modern NEMT are important given decreased support for human services spending.