How to Start an NEMT Business in Florida: A Several Part “Bambi Knows Best” State-By-State Series Part 1: Research the Florida NEMT Market Before diving into launching your NEMT business in Florida, thorough market research is key. This important step helps you navigate Florida’s diverse landscape and vibrant communities, ensuring you avoid entering an oversaturated market while pinpointing opportunities to fill gaps in existing NEMT services. For instance, you might find that while certain areas have NEMT providers catering to specific healthcare facilities, there's potential to expand your services to include popular spots like retirement communities, assisted living facilities, medical clinics or where the snowbirds flock. This approach ensures you're ready to meet the transportation needs across Florida's sprawling and sunny terrain.
1 | Identify existing NEMT providers in your area In Florida, non-emergency medical transportation (NEMT) services are indeed provided under Managed Care Organizations (MCOs) through the state's Medicaid program. MCOs play a vital role in managing transportation services for Medicaid beneficiaries to ensure they can access necessary medical appointments. MCOs in Florida coordinate transportation services for Medicaid beneficiaries. They manage networks of transportation providers, which may include taxis, specialized medical transport and ride-sharing services.
The Florida Agency for Health Care Administration (AHCA) oversees Medicaid managed care regulations to uphold quality service and safety standards.
Here are some of the most notable NEMT providers that work with these MCOs:
Modivcare MTM, Inc . : MTM is a significant provider of transportation and healthcare management services, including NEMT. They operate in various states, including Florida, under contract with MCOs.Access2Care Garzor Insurance :Elite-Star NEMT Works Uber Health Your favorite search engine. Of course, one can always perform their own search with the keywords, “NEMT providers in Florida” or get more granular with your search by typing in specific municipalities (i.e. “NEMT companies in Orlando”). 2 | Assess the demand for NEMT services Understand the demand for your NEMT business in your local Florida area by assessing whether you'll serve multiple jurisdictions or focus within a specific radius. Conduct research on local hospitals, healthcare facilities, wellness centers and other relevant health-focused establishments. Think creatively and explore beyond the conventional methods to uncover opportunities outside the norm.
Adult Day Care (ADC) Centers. These are plentiful in Florida, catering to the needs of its substantial senior population, which comprises over 20% of the state's residents. For the latest statistics, refer to the Florida Department of Elder Affairs (DOEA) or the Agency for Health Care Administration (AHCA). These agencies oversee and regulate adult day care centers, offering databases or lists of licensed facilities statewide.Dialysis Clinics. While we don't have specific data points, due to Florida's vast size, there are numerous dialysis clinics scattered across the state. Some of the largest clinics with significant presence include: Fresenius Medical Care , DaVita Kidney Care and U.S. Renal Care .Physical Therapy Centers. It’s tough to get a number on this due to diverse reporting methods and the state's extensive healthcare network. For the most accurate information, we recommend consulting Florida’s health department records, professional associations such as the American Physical Therapy Association (APTA ) or industry reports focusing on Florida healthcare facilities. Hospitals. Florida has over 340 hospitals , varying in size and specialization, from small rural facilities to large urban medical centers.Rehabilitation centers. We don’t have an up-to-date number here either, but many hospitals partner with rehab centers so it’s always best to contact them.Nursing homes and assisted living facilities. Florida has a substantial number of nursing homes to cater to its elderly population. There are approximately 685 nursing homes in Florida. These facilities provide long-term care services, including skilled nursing care and assistance with daily living activities, for elderly residents who require ongoing medical and personal care. Consult with the Florida Agency for Health Care Administration (AHCA) or the Centers for Medicare & Medicaid Services (CMS) for up to date information on this.Outpatient care centers. Similar to rehab facilities, Florida boasts numerous outpatient care centers statewide. For more details on these estimates, consider consulting your local county’s hospitals.3 | Decide on a target market Note that the population of Florida is estimated to be around 21 million people . And remember a good almost quarter of that is the elderly folk. So after thoroughly researching the NEMT market opportunities and gauging the demand across this substantial population, it’s time to identify the most viable demographic to target — whether seniors, individuals with disabilities or a broader patient population. Focusing on a specific group allows you to tailor your services and marketing strategies more effectively.
4 | Choose a specific NEMT service (or offer them all!) NEMT providers offer essential services including ambulatory, stretcher and wheelchair transportation. Start by focusing on the service that's in highest demand to effectively meet community needs. This strategic approach ensures a solid foundation and sets the stage for long-term success. Keep an eye on competitors; differentiate yourself with unique services or target underserved niches. Lastly, launch with a top-tier fleet designed for your specific service area, whether transporting individuals to adult day cares, physical therapy centers or other vital destinations.
5 | Understand the different Medicaid delivery models Before May 2014, Florida's Medicaid agency, the Agency for Health Care Administration (AHCA), worked with the Commission for the Transportation Disadvantaged (CTD) to oversee all NEMT services statewide. The CTD, an independent commission under the Florida Department of Transportation, aimed to ensure efficient, cost-effective transportation for individuals facing transportation challenges. To achieve this, CTD partnered with over 65 county-based community transportation coordinators to assist Medicaid recipients with travel needs.
Initially, 55 of Florida's 67 counties integrated NEMT with human services and public transportation, while the remaining 12 counties provided NEMT as a distinct service. In 2011, the Florida Legislature established the Managed Medical Assistance program, mandating Managed Care Organizations (MCOs) to cover NEMT among other services. By May 2014, each MCO contracted with one of three national for-profit brokers to manage NEMT under the managed care plans. These brokers in turn collaborated with various transportation providers, including taxicabs, public transit, human services providers and in some counties, the community transportation coordinators.State-by-State Profiles for Examining the Effects of Non-Emergency MEdical Transportation Brokerages on Transportation Coordination :
NEMT Model is Managed Care Organization The Operating Authority is the Federal Section 1115 Demonstration Waiver NEMT expense is classified as a “Medical Expense” 16% live below poverty (US Census 2015 5-Year Estimates) 87% live in Urbanized Areas (US Census 2010) $61.1 Million is the estimated annual NEMT 2013 expense (Source 2014 National NEMT Survey) 2,815,811 is the 2013 estimated number of annual NEMT trips 9.2% of NEMT is Public Transportation 6 | Getting Paid In Florida, NEMT providers receive payment through various methods under the Medicaid program:
Fee-for-Service (FFS): Providers submit claims directly to Medicaid for each service provided. Reimbursement rates are determined by Medicaid and vary depending on the type of service rendered and other factors.Managed Care Organizations (MCOs): Florida Medicaid operates under managed care, where MCOs are contracted to oversee healthcare services, including transportation. Providers contract with MCOs to provide NEMT services and receive payment according to negotiated terms and rates set by the MCOs.Brokers: Some MCOs or third-party brokers coordinate NEMT services for Medicaid beneficiaries. Providers contract with these brokers and receive reimbursement based on agreed-upon terms.Providers must adhere to Medicaid billing guidelines and procedures when submitting claims for reimbursement. For detailed information and specific requirements, providers should consult the Florida Medicaid program or their affiliated managed care organization.
Congratulations on completing this informative first part! Next, let's proceed to Part 2 , where we'll delve into crafting your business plan. Click here to continue, or explore other sections in the series through the table of contents.
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