Year 1 Impact of Offering Non-Emergency Medical Transportation on Care Utilization Among Low-Income and Disabled...

To examine the effects of offering non-emergency medical transportation (NEMT) on care utilization among low-income and disabled beneficiaries in Medicare Advantage (MA).

We leveraged the 2019 expansion of "primarily health related" benefits to study the impact of offering NEMT on enrollees' utilization of care. We used an event study model to compare changes in care for beneficiaries enrolled in plans that began offering a NEMT benefit in 2019 versus those in plans that did not.

We used MA plan benefit package, Medicare enrollment, and MA encounter data for years 2016-2019 to identify plans offering NEMT, low-income and disabled beneficiaries enrolled in these plans, and model covariates.

Offering of NEMT was associated with little change in utilization. We found a statistically insignificant 1.4% increase in the probability of receiving an annual wellness visit (Coef. 0.006; 95% CI, -0.007-0.018, p = 0.371) and a 4.0% decrease in ambulance use days (Coef. -0.012; 95% CI, -0.033-0.010, p = 0.290). We did not find evidence of statistically significant or economically meaningful changes in outpatient evaluation and management, procedure, imaging, and emergency room visits.

In the first year of NEMT benefit offerings by MA plans, we found no detectable evidence of associated changes in care utilization among low-income and disabled beneficiaries. Conclusions about the potential value of coverage for NEMT are limited by the short evaluation period and lack of data on NEMT benefit generosity and use.