How to Start an NEMT Business in Idaho: A "Bambi Knows Best" State-By-State Series

Part 1: Research the Idaho NEMT Market

Idaho isn’t just known for its stunning landscapes and outdoor adventures — it's also a promising market for non-emergency medical transportation (NEMT) services.

Before you dive into the process of launching your NEMT business in this gem of a state, it's crucial to conduct thorough market research. Idaho’s blend of bustling cities, rural communities and vast natural areas creates a unique demand for NEMT services. Here’s how to navigate this diverse market:

1 | Identify Existing NEMT Providers in Idaho
Understanding the landscape of current NEMT providers across Idaho is essential for spotting opportunities and managing competition. The Idaho Department of Health and Welfare oversees Medicaid-funded NEMT services, ensuring compliance with both federal and state regulations. Key providers include:

• MTM, Inc.: As Idaho’s primary NEMT broker, MTM coordinates transportation for Medicaid recipients statewide.
• Valley Regional Transit: Provides transit services in the Treasure Valley area, with options for paratransit and NEMT under the names of Access Paratransit, Beyond Access, Meridian Medical Transportation, Rides2Wellness and more!
• Public Transportation Providers: Smaller transit agencies in regions like Twin Falls offer NEMT options.
• Uber Health: Operates in various cities of Idaho, using a HIPAA-compliant platform for scheduling and tracking patient rides.

We also recommend simply consulting your local directories and online resources to identify additional NEMT providers in Idaho’s different regions.

2 | Assess the Demand for NEMT Services
Evaluate the demand for NEMT services by focusing on major healthcare facilities and community needs across Idaho such as the following:

• Adult Day Care Centers: These centers offer services for the elderly and individuals with disabilities. There are many of them across Idaho, providing an essential market for NEMT services. For the most current information, check with the Idaho Commission on Aging.
• Dialysis Clinics: Numerous clinics are spread throughout the state, operated by major healthcare providers like DaVita and Fresenius Medical Care.
• Physical Therapy Centers: Idaho has a robust network of PT centers, providing ongoing rehabilitation services. The Idaho Physical Therapy Association can provide the most updated information on the number of centers and more.
• Hospitals: Idaho currently has around 47 hospitals, according to the American Hospital Directory. This includes major facilities like St. Luke’s in Boise, Kootenai Health in Coeur d'Alene, and Eastern Idaho Regional Medical Center in Idaho Falls. The count of 47 encompasses various types of hospitals, including non-federal, short-term acute care hospitals, and does not account for all specialty or long-term care facilities.
• Nursing Homes and Assisted Living: Idaho is home to a large number of licensed nursing homes and assisted living facilities, making up a significant portion of the NEMT market. Check with the Idaho Department of Health and Welfare for the latest statistics.
• Outpatient Care Centers: Essential to Idaho's healthcare network, these centers present additional opportunities for NEMT services and are often part of a hospital's network so you can learn about some of these when you’re already connecting with hospitals.

3 | Decide on a Target Market
Identify your target demographic based on the demand from various healthcare facilities. Whether you focus on seniors, individuals with disabilities or a wider patient base, tailoring your services to meet these needs will enhance your business effectiveness and overall marketing efforts.

4 | Choose Specific NEMT Services
Determine which NEMT services are in high demand in Idaho. Specializing in areas such as senior transportation, medical appointments or rural health access will help you address local needs and establish your niche in this growing billion dollar NEMT market.

5 | Understand Medicaid Delivery Models in Idaho
Idaho’s Medicaid program, coordinated by the Idaho Department of Health and Welfare, plays a significant role in NEMT services. The state uses a broker model, with MTM, Inc. managing NEMT services for Medicaid recipients. Here’s an overview of Idaho’s NEMT model:

• NEMT Model: Brokered system, with MTM, Inc. as the primary broker.
• Operating Authority: Idaho Medicaid State Plan via the 1902(a)(70) State Plan Amendment
• NEMT Expense Classification: Medical Expense
• Poverty Rate: Approximately 15% live below the poverty line
• Urban Population: About 51% live in urbanized areas
• Estimated Annual NEMT Expense: $20 Million
• Estimated Number of Annual NEMT Trips: 1,195,000
• Public Transportation: 1.5%

6 | Getting Paid
Idaho Medicaid compensates transportation providers through a brokered system. Here’s how the payment process generally works:

• Brokered System: Providers contract with MTM, Inc. for coordination and payment of NEMT services.
• Fee-for-Service (FFS): In some cases, providers may submit claims directly to Medicaid for reimbursement.

Ensure compliance with Medicaid billing guidelines when submitting claims. For specific details, consult the Idaho Department of Health and Welfare or MTM, Inc. directly.

Prepare to navigate Idaho's NEMT landscape with precision and insight. Stay tuned for Part 2, where we’ll guide you through developing a business plan tailored to Idaho’s unique regulations and market conditions. Continue with us, or jump ahead via the TOC to explore more in our series and pave your path to success!

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